Methods: A two-group randomized control trial is being implemented with a targeted sample of 100 low-income, first-time adolescent mothers, ages 15 to 19 years old, with infants (0 to 6 months of age) to obtain evidence for efficacy, feasibility, acceptability, and satisfaction related to T4TM. Participants are randomly assigned to the intervention group (n = 50) or control group (n = 50). Adolescent mothers must be a primary caretaker of the infant who feeds her infant at least once a day. Adolescent mothers are recruited from Maternal Infant Health Programs, a program for pregnant women and infants who are Medicaid-eligible, promotes healthy pregnancies, positive birth outcomes, and healthy infants through home and office visits during the first year of life. The intervention consists of six weeks of daily challenges via the T4TM website within four urban, Michigan counties. Tools4Teen Moms challenges are being delivered for six weeks starting when the infant is four to six weeks old. T4TM includes cell phone text message reminders, an infant feeding website, and a Facebook interface to increase infant-centered feeding. Participants perform daily behavioral challenge activities, which consist of daily challenges for six weeks via the T4TM website. Daily challenges focus on promoting maternal-infant feeding interaction and healthy feeding practices. Data are collected at three time points (baseline, when the infant is 10-12 weeks old, and six months old), using self-report and anthropometric measures. Data analysis for challenge feasibility: For those in the intervention group, the number and percent of participants who completed all the challenges will be determined. Acceptability and Satisfaction: The results of the satisfaction survey will be summarized and evaluated for overall satisfaction. Open-ended questions will be transcribed to identify key reasons for satisfaction levels and suggestions for improvement.
Results (Preliminary): Currently, the participant age range is 16 to 19 years with a mean of 18 years; 33% of participants identify themselves as Hispanic/Latina, 27%, identify as Black/African American, 20% White, 7% Asian, and 13% as multiracial. Most participants (87%) are not currently employed. At the time of data collection 33% of participants were currently breastfeeding, while 67% were not; of the 67% who were not currently breastfeeding, 50% had breastfed their baby at some point. Birth weight of babies in the study ranges from 5.58-9.19 lbs (mean = 7.29 lbs).
Preliminary results indicate engagement with the T4TM website and challenges. Participants visited the website an average of 28/42 days. Many participants have retroactively completed challenges, meaning they visited the “Past Challenges” to complete challenges that had been posted earlier that week. The average minimum challenge exposure for completed participants thus far is 31/42. Preliminary results show that participants engage with quizzes available on the T4TM website; participants have completed an average of 3/4 quizzes.
Feedback from participants indicates enjoyment of the intervention. All participants agreed that they found the website helpful, they learned a lot about infant feeding from this program, and they would recommend T4TM to a friend for infant feeding advice. Participants agreed that they were satisfied with the challenges presented in the T4TM intervention. One participant expressed her opinion of the program: “It’s a good program; I like it because it teaches me new things about becoming a great mother, and I really appreciate this program. Thank you so much!”
Conclusions: This study is in progress. Preliminary evidence supports use of text messaging and daily challenges to engage adolescent mothers in healthy infant feeding practices. Nursing can augment education with skill application via social media.
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