Appendix Table A1.

Parents as Teachers Plus Home Visit Curriculum

Visit	Topic	Objectives
1	Healthy weight gain in pregnancy	Improve understanding of healthy weight gain during pregnancy and learn how to chart weight gain.
		Set healthy goal and discuss value for mom to stay involved.
		Improve understanding of physical activity in a healthy pregnancy.
2	Healthy foods and beverages	Improve understanding of current fetal development and reasons why nutrient-dense foods are so important for optimal ongoing development.
		Assist participant in discovering high-calorie foods/beverages she consumes and ways to replace those foods/beverages with healthier choices.
		Explore participant's experience/thoughts/beliefs about breastfeeding.
3	Self-monitoring	Improve understanding of appropriate portion sizes and provide opportunity to measure out foods in the home.
		Assist parent in learning how to self-monitor intake and physical activity and provide opportunity to use pedometer.
		Improve understanding about benefits of breastfeeding.
4	Meal planning	Improve understanding of importance of regular routines, meals, and snacks.
		Assist parent in developing a weekly food plan and grocery list.
		Explore reasons participant might not want to breastfeed.
5	Grocery shopping	Assist participant in discovering how to purchase healthier foods in grocery store, within her budget.
		Practice reading food labels on actual foods in home.
		Explore thoughts and strategies about breastfeeding in public/away from home.
6	Cooking	Improve understanding of the role cooking can play in providing healthy and cost effective meals.
		Provide opportunity to prepare a simple recipe in the home.
		Improve understanding of Missouri WIC food package for breastfeeding woman/infant.
7	Eating out	Provide opportunity to compare cost of eating out to meal prepared in home.
		Build skills in making best choice when eating out.
		Improve understanding of benefits of breastfeeding versus formula feeding infant.
8	Infant feeding	Improve understanding of basic breastfeeding techniques.
		Practice breastfeeding positions with a doll.
		Assist participant in developing a plan for infant feeding immediately following birth.
9	Problem solving–self efficacy	Assist participant in discovering who will be significant people who will help her after the baby is born and how they can support her.
		Identify positive changes she has made in her lifestyle during her pregnancy.
		Assist participant in discovering signs of hunger and how she knows her baby is getting enough.
10	Maintain behaviors	Build skills in maintaining lifestyle changes following delivery.
		Provide opportunity for participant to discuss any concerns/anxieties she is having about the upcoming birth of her baby.
		Improve understanding of how participant might feel emotionally and physically after her baby is born.