Engaging disadvantaged mothers through mHealth to support infant feeding behaviours that promote healthy weight gain

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Eating behaviours are learned from the beginning of life and it is these habits that are carried throughout the life stages, affecting weight gain. Parental feeding behaviours including early cessation of breast feeding, formula feeding, early introduction to solids and introduction to non-core foods are considered to be correlates of excess weight gain. Further, there are socio-economic disparities which coexist, where families from a lower socio-economic status (SES) are more likely to practise unhealthy feeding behaviours. It is essential to understand how to effectively encourage these parents to make healthier infant feeding decisions. One emerging approach is to deliver health interventions through digital technologies also known as mobile health (mHealth). Interventions delivered through an mHealth approach have been shown to influence positive behaviour change in the management and prevention of chronic diseases. Yet there are very few studies which have developed mHealth interventions to support infant feeding. The research in which this thesis is embedded was designed to develop and test an mHealth intervention (the Growing healthy program) that delivers expert advice to mothers of young infants about healthy infant feeding behaviours. This thesis includes a number of studies that were conducted to guide the development of the Growing healthy program and to evaluate the outcomes regarding participant engagement with the program and the uptake of healthy infant feeding behaviours. […] This thesis provides a unique contribution to the existing literature by reporting the findings of a feasibility study to support mothers with healthy infant feeding behaviours through an mHealth program. As well as being the first infant feeding program delivered through mHealth, it is also the first study to utilise an Engagement Index to measure participant engagement in an mHealth intervention. This work therefore provides valuable information to inform future trials regarding intervention components that enhance engagement among this demographic. The Engagement Index provides an effective method to analyse engagement that can be implemented and adapted to suit any mHealth intervention.
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