# “Preventing Early Childhood Obesity in American Indian Populations”

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $500,232

## Abstract

Project Summary
The goal of this study “Preventing Early Childhood Obesity through a Home-Based
Parenting Intervention,” is to evaluate the impact of a home-based childhood obesity
prevention intervention called Family Spirit Nurture (FSN) on mother’s feeding practices and
responsive feeding behaviors as well as infant and toddler nutrition, physical activity (PA), and
growth patterns through a randomized controlled trial. The study population is the White
Mountain Apache (Apache) Tribe and Navajo Nation, who have a 35-year history of pioneering
research in collaboration with the Johns Hopkins Center for American Indian Health (JHCAIH).
FSN builds on the evidence based Family Spirit parenting intervention, developed and
evaluated by JHCAIH. By integrating comprehensive infant and young child feeding (IYCF), diet,
and PA components to the Family Spirit intervention (making it Family Spirit-Nurture [FSN]),
FSN is poised to lower obesity risk among American Indian (AI) children. Apache and Navajo
expectant mothers (< 28 weeks gestation) aged 14-22 (N=338) will be randomized to receive
the FSN intervention +Optimized Standard Care (OSC) or OSC alone. FSN consists of 36
comprehensive home-based curricular lessons taught in 60-minute visits from 28 weeks
gestation through 18 months postpartum. OSC consists of transportation assistance to clinic-
based prenatal and well-baby visits and referrals to community resources.
Primary study aims are to compare the efficacy of FSN +OSC vs. OSC alone on: 1) mothers’
feeding practices and behaviors; 2) infant and toddlers’ diet; 3) infant and toddlers’ PA; and 4)
infant and toddlers’ BMI z-scores. We will evaluate study aims through a mixed method
assessment conducted at nine time points: baseline, birth, 2, 4, 6, 9, 12, 18, 24 months
postpartum. This proposal is urgent, innovative and has potential for significant impact because:
1) AI infants, toddlers and youth have the nation’s highest rates of obesity; 2) FSN is designed
to prevent obesity in early childhood by promoting parenting practices that reduce obesity risk
while simultaneously addressing primary caregiver’s psychosocial and home environment
factors; and 3) FSN builds on the Family Spirit intervention which was successfully evaluated in
Apache and Navajo communities then scaled to 60+ additional tribal communities. If study aims
are met, we will demonstrate the efficacy of a new Community Health Worker model for obesity
risk reduction—a current necessity to overcome human resource and health system deficits in
low income, rural and, often, culturally diverse communities.

## Key facts

- **NIH application ID:** 10073528
- **Project number:** 5R01HD087407-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Mary Allison Barlow
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $500,232
- **Award type:** 5
- **Project period:** 2017-01-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10073528

## Citation

> US National Institutes of Health, RePORTER application 10073528, “Preventing Early Childhood Obesity in American Indian Populations” (5R01HD087407-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10073528. Licensed CC0.

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