Infant feeding practices and active play are among the known early-life modifiable factors for healthy weight gain and the prevention of obesity. Yet, there is a lack of evaluated interventions to improve access to postnatal care for culturally and linguistically diverse migrant families. Reduced access to healthcare impacts the support mothers receive for their health and the health of their children in this critical early period of life. In Australia, women and infants from culturally and linguistically diverse backgrounds, compared to Australian-born women, are less likely to use health services, more likely to report negative experiences of maternity care and more likely to report depressive symptoms. With migration increasing worldwide, reducing health inequities among culturally and linguistically diverse migrants is a global priority. This is partly due to language barriers, unfamiliarity with a different health system and cultural differences. Women from culturally and linguistically diverse backgrounds who migrate to high-income English-speaking countries, such as Australia, can face challenges accessing child and family health services. These findings support the potential for program refinements and progression to an effectiveness trial. Our results highlight the importance of in-language resources and individualised bi-cultural nurse support by telephone for supporting culturally and linguistically diverse migrant families with infant feeding and active play. The culturally adapted Healthy Beginnings program was feasible to deliver and acceptable to Arabic- and Chinese-speaking mothers. Mothers who completed more nurse support calls generally expressed greater acceptability. The qualitative analysis of follow-up interviews with 42 mothers (22 Arabic- and 20 Chinese-speaking mothers) and 10 program delivery staff highlighted the perceived value of the program and the positive role of bi-cultural nurses and in-language resources. Most mothers ( n = 127, 78%) completed at least one nurse support call. Of 163 mothers who completed the baseline survey, 95% completed the program ( n = 8 withdrew) and 83% completed the 6-month survey ( n = 70 Arabic- and n = 65 Chinese-speaking mothers). ResultsĪt recruitment, 176 mothers were eligible and consented to participate. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses). A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. In 2018–2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. In this article, we aimed to evaluate the feasibility of the culturally adapted program. The cultural adaptation process has been published separately. To improve engagement with culturally and linguistically diverse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. Healthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life.
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