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TIFS FEASIBILITY STUDY


Introduction

The purpose of the Feasibility Study was to test the feasibility in providing a tailored curriculum that encourages a mother to introduce solid foods to her infant at the recommended four to six months of age. The curriculum was designed to be implemented into existing community programs and taught by paraprofessionals. The Theory of Dependent Care Agency (Orem, 2001) is the overarching theoretical framework for the intervention.


Sample
  • 29 mothers either pregnant or had an infant who was 0-4 months old at the beginning of the study
  • 14 African American and 15 White mothers who had limited incomes
  • Infants at the beginning of the lessons could only have previously been fed breast milk or formula

Intervention Sites

Counties throughout Michigan:
  • Crawford County
  • Jackson County
  • Oakland County
  • Roscommon County
  • Wayne County

Lessons

Seven program associates (instructors) from either the Michigan State University Extension Building Strong Families or The Breastfeeding Initiative programs conducted Lessons 1-6 at each motherís home.


Data Collection

Data were collected from mothers and instructors.

Mothers
  • Completed a Pre-Evaluation prior to Lesson 1
  • Completed a Post-Evaluation following Lesson 6
  • Completed a Parent Survey after completion of all six lessons.
  • Completed a Six month Post Evaluation via telephone when the infant was six months old
Instructors
  • Completed an Instructor Survey after conducting each lesson with all mothers
  • Attended a Review Session held at MSU after all lessons had been conducted

Results

The TIFS curriculum was pilot-tested for feasibility with 29 low-income mothers (n=14 African American and n=15 white mothers) participating in one of two education programs delivered by Cooperative Extension. The lessons were delivered by 7 paraprofessional instructors in 5 different counties. Mothers and paraprofessionals completed evaluation forms after each lesson and at the end of the final lesson. In addition, 6 instructors attended a focus group session with the study investigators to discuss their perceptions of the curriculum, including ease of use, suitability for the target audience, and effectiveness.

Overall, the mothers felt the lessons to be helpful and felt the curriculum overall helped them understand how to tell when their babies were ready for solid foods. The parts of the lessons they particularly enjoyed were the hands-on activities, particularly the scrap booking pages they put into their workbooks, including those pages which included photos of their own babies. Most mothers enjoyed the video segments shown at each lesson and felt it helped them to better understand the lesson content.

The instructors were generally able to deliver each lesson in about 60 minutes, although some mothers required a bit more time to understand some lessons. The instructors found the use of the hands-on activities helpful in engaging the mothers. They reported that activities that were to be completed and returned in later lessons provided mothers with a sense of pride and accomplishment. Other activities, including the scrap booking pages, encouraged the mothers to spend more time on learning and less time on activities such as TV watching. The instructors found the video segments useful in explaining topics, especially when the segments provided a visual representation (such as the size of babyís stomach). Instructors felt the lessons were most beneficial for women who already had their baby, or were late in their pregnancy, than for women early in their pregnancy. Overall, the lessons and handouts were felt to be appropriate for their target.

Of the initial 29 mothers who started the lessons, 28 completed all six lessons and 25 completed the six-month post evaluation. Of the 25 mothers who completed the six-month post evaluation, only one mother introduced solids early before the AAP recommendation of 4-6 months of age.

The TIFS curriculum will next be tested for efficacy using a controlled, randomized intervention.

Reference

Orem, D. E. (2001). Nursing Concepts of Practice (6th Edition). St. Louis: Mosby.

Note:

A solid food is defined as anything other than breast milk or formula.





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