This program is delivered to women who are pregnant for the first time and are from areas that are economically disadvantaged and is intended to impact women and their children.

Healthy Beginnings, a home-based program, is designed to teach first-time mothers about infant feeding practices, nutrition, and active play to promote healthy behaviors for the children. The long-term goal of the program is to prevent children from becoming overweight or obese.

A randomized controlled trial was conducted with 667 first-time pregnant women living in socially and economically disadvantaged areas of Sydney, Australia. The study found that breastfeeding rates were significantly higher in the intervention group compared to the control group at 6 and 12 months. At 12 months, the median breastfeeding duration was significantly higher in the intervention group at 17 weeks, while the control group reported breastfeeding for a median of 13 weeks. The intervention also resulted in a significantly later introduction of solid foods, which reduced the proportion of mothers who introduced solids before 6 months by 12%. A follow-up study examined infant outcomes in 465 families who had completed the original intervention. At 2 years after the initial intervention ended, children's body mass indexes were significantly lower in the intervention group compared to the control group. However, these differences were no long observed at 3.5 years or 5 years after the program had ended. No significant differences were observed in the percentage of children who were categorized as overweight or obese between groups at 3.5 and 5 years. Additionally, no significant differences between groups were observed for dietary behaviors, physical activity, TV viewing time, or quality of life.

Healthy Beginnings is a home-based program in which trained nurses visit women once during their pregnancy and five times after the baby is born. Each home visit corresponds to common milestones in early childhood development. At each visit, nurses observe the parent-child contact and proceed with the following activities:

• Study parent-child feeding interactions and behaviors that promote physical activity/inactivity in the child;  
• Identify parental needs in relation to nutrition, feeding, and age-suitable physical activity using a checklist;  
• Provide counseling and problem-solving activities for parents based on the prior assessment; and
• Offer key discussion points that address the following: infant feeding practices, infant nutrition and active play, family physical activity and nutrition, and social support.  

The key program messages that nurses focus on include: "Breast is best," "No solids for me until 6 months," "I eat a variety of fruits and vegetables every day," "Only water in my cup," and "I am part of an active family."

The program began in 2007 with 667 pregnant, Australian women. The extent to which the program has been used since then is unknown.

Healthy Beginnings is delivered by nurses who are trained by health promotion practitioners to deliver program specific content that is focused on maternal and infant feeding and activity behaviors.

Considerations for this program include finding and training nurses to deliver the program; acquiring participant buy-in and commitment; scheduling six home visits; understanding the content of this program was developed from recommendations from the Australian Guide to Healthy Eating, the National Physical Activity Guidelines, and the National Health and Medical Research Council Dietary Guidelines and these guidelines may not be suitable for use in other countries; and recognizing the program is only currenly offered in Australia and the UK.  

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing Healthy Beginnings, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

The program lasts over a year. The first home visit occurs at 30 to 36 weeks gestation. Additional home visits occur at 1-, 3-, 5-, 8-, 12-, 18-, and 24-months postpartum. Each home visit lasts 1 to 2 hours.

The program costs approximately $709 (Australian Dollar) per child.

To move Healthy Beginnings to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact Li Ming Wen by phone +02 915 9056 or email liming.wen@sydney.edu.au or the Sydney Local District Health Promotion Unit by phone +612-9515-9055, fax +612-9515-9056, email healthybeginnings@health.nsw.gov.au, or visit http://www.healthybeginnings.net.au/contact/

http://www.healthybeginnings.net.au/