Adapting an Evidence-Based Infant Feeding and Nutrition Program to Promote Healthy Growth and Development in Latinx Families of Low Income

Abstract

Objective: To describe the cultural adaptation of an evidence-based early childhood obesity prevention intervention for Latina mothers and nonmaternal caregivers in families of low income who speak diverse languages.

Design: Participatory intervention adaptation methods were used to complete the first and second steps of the cultural adaptation process: (1) gathering information and (2) preliminary intervention adaptations.

Setting: Southern California, US.

Participants: Mothers of infants aged 4-6 months and their trusted caregivers (n = 46 mother-caregiver dyads) and members of an intervention workgroup (n = 8).

Intervention: Healthy Beginnings Communicating Healthy Beginnings Advice by Telephone was adapted for Latina mothers and nonmaternal caregivers.

Main outcome measures: Mother and caregiver recommendations for intervention design.

Analysis: We used qualitative approaches to analyze textual data for the cultural adaptation process. Notes and observations from the recorded intervention workgroup meetings were incorporated into the intervention design.

Results: Content adaptations included cultural meanings of infant feeding, maternal mental health, and infant feeding practices. Intervention delivery changes included caregiver involvement, reduced in-home session time, increased session frequency, and intervention delivery by the community health workers.

Conclusions and implications: Nonmaternal caregivers play an important role in intervention adaptation by ensuring that early childhood obesity prevention efforts are culturally and linguistically relevant.

Keywords: Latinos; caregivers; early childhood obesity prevention; healthy growth and development; infant feeding; qualitative research.