The Baby Books Project tests whether embedding educational information into baby books can improve the health and wellbeing of first-time mothers and their young children.
This study tests the efficacy of embedding educational information (i.e., pediatric anticipatory guidance) into baby books that first-time mothers read to their infants. This 3-group longitudinal study recruited first-time mothers in their third trimester of pregnancy, randomly assigned them to conditions, and followed them until the child was 18 months of age. One group received educational baby books, another group was given the same illustrated books with non-educational text, and the third group was not given any books. Thus, the effects of educational reading could be parsed from the effects of reading alone. The study aimed to test whether embedding pediatric anticipatory guidance in picture books is an effective method for increasing maternal knowledge of child development, parenting strategies, and safety practices, improving parenting beliefs and attitudes (e.g., parenting efficacy, importance of reading, use of corporal punishment), supporting optimal parenting practices (e.g., breastfeeding and nutrition, responsiveness, safety practices), improving maternal health (stress, depression), and supporting children's healthier development (injuries, illness, immunizations, and linguistic, social, and cognitive development). Survey and observational data collection occurred in participants' homes during their third trimester of pregnancy and when their child was 2, 4, 6, 9, 12, and 18 months of age. Twelve phone call interviews were conducted between these home visits. When children were 18 months, a retrospective medical chart audit was conducted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
198
educational information from Bright Futures Guidelines for Health Supervision for birth to 18 months
Given free books prenatally and at 2, 4, 6, 9, 12, and 18 months postpartum
University of California, Irvine
Irvine, California, United States
Vanderbilt University
Nashville, Tennessee, United States
Change in knowledge of child development and parenting
Measured with Opinions about Babies questionnaire
Time frame: Change from Baseline (pregnancy) to 18 months postpartum
Change in Reading Practices
Self-reported joint reading practices
Time frame: Change from 2 to 18 months postpartum
Parenting Stress
Measured with the Parenting Stress Index
Time frame: Change from 2 to 18 months post-partum
Costs
Maternal costs due to their own and their child's illness/injury, use of substances, and purchase of food was measured with the Incurred Cost Questionnaire.
Time frame: Cumulative costs over study duration
Safety Practices
Measured with the Home Safety Assessment, an observational and self-report measure of safety practices in the home, car, and outside
Time frame: 2, 4, 6, 9, 12, and 18 months postpartum
Attitudes about Corporal punishment
Adolescent-Adult Parenting Inventory
Time frame: 2, 6, 12 and 18 months postpartum
Maternal Depressive Symptoms
Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale.
Time frame: Change from baseline (pregnancy) to 18 months postpartum
Beliefs about the Importance of Reading to Children
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Maternal beliefs about the importance of reading was measured with the Modified Parent Reading Belief Inventory
Time frame: Change from baseline (prenatal) to 18 months postpartum
Injuries and illnesses
Child illnesses injuries were measured with the Incurred Cost Questionnaire and through a retrospective medical chart audit.
Time frame: 16 months (from 2 to 18 months postpartum)
Quality of Parent-Child Interaction
Video recording and in-vivo coding of mother-child dyads during play and reading.
Time frame: Change from 2 to 18 months postpartum
Home environment and parenting
measured with the Home Observation for Measurement of Environment (HOME).
Time frame: Change from 2 to 18 months postpartum
Receptive and Expressive language
Measured with the Preschool Language Scale - Fourth Edition (PLS4).
Time frame: Change from 6 to 18 months postpartum
Cognitive and neurological development screening
Measured with the Bayley Infant Neurodevelopmental Screener (BINS)
Time frame: 4, 6, 9 months postpartum
Infant nutrition
Infant Nutrition Interview measured the introduction of news foods, types of foods, and serving portions at each time point.
Time frame: 2, 4, 6, 9, 12, and 18 months postpartum
Breastfeeding intentions and practices
measured with the Breastfeeding Intentions and Practices Scale
Time frame: prenatal and postnatal every visit until no longer breastfeeding
Pregnancy uplifts and Hassles
measured with the Pregnancy Experience Scale
Time frame: Baselines (pregnancy)
Parenting Satisfaction
measured with the Parenting Satisfaction Scale
Time frame: Change from 2 to 18 months postpartum
Parenting Self-Efficacy
Measured with the Maternal Self-Efficacy Scale
Time frame: Change from 2 to 18 months postpartum
Reading self-efficacy
measured with the Reading Self-Efficacy Scale
Time frame: Change from 2 to 18 months postpartum
Cognitive Development
measured with Exploratory Play Task
Time frame: 12 and 18 months postpartum
Immunizations, medical visits, and growth status
measured through a retrospective medical chart audit.
Time frame: 18 months postpartum