Implementing Healthy Beginnings Meets HHS Criteria

Model implementation profile last updated: 2015

Model overview

Theoretical approach

Healthy Beginnings was designed to prevent children from becoming overweight and obese. The program drew on research demonstrating the link between being overweight and obese during childhood and immediate and long-term adverse health and social-emotional effects. Recognizing that a child’s environment influences nutrition and physical activity, the program used a family-focused approach to address risk factors associated with childhood obesity.

The model emphasized the following messages:

  • “Breast is best”
  • “No solids for me until 6 months”
  • “I eat a variety of fruit and vegetables everyday”
  • “Only water in my cup”
  • “I am part of an active family”
  • “TV away let’s go play”
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Implementation support availability

Healthy Beginnings was a demonstration project designed by researchers from Sydney and South Western Sydney Local Health Districts Health Promotion Service and the University of Sydney, in Australia. It was implemented from 2007 to 2010.

Ongoing technical assistance is not available.

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Intended population

Healthy Beginnings served first-time mothers of infants from socially and economically disadvantaged areas of South Western Sydney.

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Targeted outcomes

The model aimed to prevent childhood obesity by improving child and family eating patterns, reducing sedentary activities such as television viewing, and increasing physical activity.

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Model services

In Healthy Beginnings, nurses provided home visits to first-time mothers with newborns. Nurse home visitors addressed the following topics during each visit: infant nutrition and physical activity, family nutrition and physical activity, and family social support. Using questions tailored to the child’s age, the nurses initiated discussions and provided information on topics listed in a visit checklist. The home visitors offered referrals if the family had questions or concerns unrelated to the discussion topics. Telephone support was available between visits.

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Model intensity and length

Families received eight home visits at the following stages: the prenatal period, and at 1, 3, 5, 8, 12, 18, and 24 months. Each visit ranged in length from 45 to 90 minutes. The visits were designed to coincide with early childhood developmental milestones related to feeding practices, nutrition and physical activity, and parent-child interactions.

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Adaptations and enhancements

No adaptations or enhancements have been made to the model.

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Organizational requirements

The Sydney and South Western Sydney Local Health District Health Promotion Service oversaw and supported program implementation. The Health Promotion Service develops, implements, and evaluates community-based programs designed to reduce health disparities.

No information was available about the fidelity guidelines that implementing programs or home visitors were required to meet.

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Staffing requirements

Specially trained early childhood nurses conducted the home visits. No information was available on the type of supervisory staff required to implement the program or the minimum requirements for supervisors.

The home visitors documented all aspects of their contact with the families and provided regular reports to the developer on questions and issues that arose.

The model required the nurse home visitors to participate in pre-service training. Before conducting home visits, the nurses received training on the following topics:

  • Developing respectful family partnerships
  • Early brain development; attachment theory; infant states, cues, and state modulation
  • Measuring child’s weight and length
  • Nutrition, including infant feeding, introduction of solids, water as main other drink, cup feeding, serving sizes, fruit and vegetables, family food, reading labels, and healthy snacks
  • Australian Breastfeeding Association guidelines
  • Grief and loss in the perinatal period
  • Play training
  • Child protection
  • Food security
  • Pre- and postnatal exercises
  • Physical activity training, including stages of change model and motivational training

The model required the nurse home visitors to participate in two hours of in-service training each month.

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