TYPE Original Research
PUBLISHED 29 September 2022
DOI 10.3389/fpubh.2022.986330
OPEN ACCESS
EDITED BY
Jessica Sophia Gubbels,
Maastricht University Medical
Centre, Netherlands
REVIEWED BY
Tonia Vassilakou,
University of West Attica, Greece
Alan Preston,
Ciencia Puerto Rico (CienciaPR),
Puerto Rico
*CORRESPONDENCE
Cristina Palacios
cristina.palacios@fiu.edu
SPECIALTY SECTION
This article was submitted to
Children and Health,
a section of the journal
Frontiers in Public Health
RECEIVED 05 July 2022
ACCEPTED 12 September 2022
PUBLISHED 29 September 2022
CITATION
Macchi AK, Banna J, Moreira S,
Campos M and Palacios C (2022)
Effect of a Short Messaging Service
(SMS) intervention delivered to
caregivers on energy, nutrients, and
food groups intake in infant
participants of the WIC program.
Front. Public Health 10:986330.
doi: 10.3389/fpubh.2022.986330
COPYRIGHT
© 2022 Macchi, Banna, Moreira,
Campos and Palacios. This is an
open-access article distributed under
the terms of the Creative Commons
Attribution License (CC BY). The use,
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original author(s) and the copyright
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does not comply with these terms.
Effect of a Short Messaging
Service (SMS) intervention
delivered to caregivers on
energy, nutrients, and food
groups intake in infant
participants of the WIC program
Alison K. Macchi
1
, Jinan Banna
2
, Stephanie Moreira
2
,
Maribel Campos
3
and Cristina Palacios
1
*
1
Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work,
Florida International University, Miami, FL, United States,
2
Department of Human Nutrition, Food
and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at
Manoa, Honolulu, HI, United States,
3
Center for Community Outreach for Health Across the
Lifespan (COHeAL), University of Puerto Rico, San Juan, PR, United States
Objectives: To test the effect of a weekly test message (SMS) intervention for
improving feeding practices on infant intake of energy, nutrients, and specific
food groups.
Methods: This study was a multi-site, randomized clinical trial, in 202
caregivers of healthy term infants participating in either the Puerto Rico or
Hawaii WIC program. Participants were randomized to receive weekly SMS
about either infant’s general health issues (control) or SMS for improving
feeding practices (intervention) to complement WIC messages for 4 months.
Anthropometrics and demographics were assessed at baseline. A validated
infant food frequency questionnaire was assessed at the four-month visit to
assess intake of general food groups. Data was summarized as median (25th
and 75th percentiles) or percentage and differences between study arms was
compared using Mann Whitney or chi-square.
Results: A total of 163 participants completed the study (n = 84 control and n
= 79 intervention). Baseline characteristics were similar between both groups.
At 4–6 months of age, compared to the control group, the intervention group
had a significantly higher intake of total grains (0.28 oz; 0.00, 0.60; P = 0.033),
protein (13.5 g, 10.5, 18.3; P = 0.022), calcium (472 mg; 418, 667; P = 0.012),
and zinc (4.39 mg; 2.61, 6.51; P = 0.028). No differences were seen in the other
food groups, including breastmilk.
Conclusions for practice: Feeding SMS to complement WIC messages led to
higher intakes of some key nutrients but did not have an overall improvement
in the intake of food groups. Messaging also did not delay the introduction of
complimentary foods or improve breastfeeding rates. Future studies should
evaluate the use of more intensive SMS interventions for continued care
between WIC visits.
KEYWORDS
Short Message Service (SMS), intervention, infant, energy consumption, nutrient
intake, food groups and beverages consumption
Frontiers in Public Health 01 frontiersin.org