OBJECTIVE: To test the feasibility, acceptability and preliminary impact of Parents and Tots Together (PTT), a family-based obesity prevention intervention, in Canada.PARTICIPANTS: Canadian parents of preschoolers (aged 2-5 years).SETTING: Ontario Early Years centres in southwestern Ontario. INTERVENTION:A pilot randomized controlled trial involving 48 parents who received either the PTT intervention (n = 27) or an attention-matched control home safety intervention (n = 21). To evaluate the feasibility of PTT, we assessed participant retention and outcome evaluation completion rates. To evaluate acceptability, we assessed program attendance and parents' responses to program satisfaction surveys. To evaluate preliminary impact, we assessed children's body mass index (BMI) at baseline, after intervention (end of 9-week intervention) and at 9-month follow-up. As well, at each time point, parents completed surveys assessing stress and self-efficacy related to parenting, children's sleep, activity, TV viewing and diet. OUTCOMES: Retention rates were high in the intervention (93%) and control (84%) study arms, and 87% of parents reported that they would highly recommend PTT to a friend. At 9-month follow-up, intervention parents reported lower parenting stress (β = 15.83, 95% confidence interval [CI] 29.57, 2.07, p = 0.02) and greater self-efficacy in managing their child's behaviour (β = 0.16, 95% CI 0.002, 0.33, p = 0.05) than control parents. PTT had minimal influence on children's weight-related behaviours and BMI. CONCLUSIONS:The results suggest that PTT can feasibly be implemented and tested in the Canadian context. Preliminary impact results suggest that the program may be effective in changing general parenting; however, program content should be modified to adequately address children's weight-related behaviours.

BackgroundSleep and physical activity are two health behaviors associated with improved smoking cessation outcomes. Text message-based interventions have previously been used to promote physical activity and smoking cessation; however, this type of intervention has not targeted sleep habits. This study examined the effectiveness of a text message-based active control intervention in improving sleep and physical activity habits among a U.S. national sample of young adult smokers participating in a smoking cessation intervention.MethodsThis study was a secondary analysis of data from the Stop My Smoking USA randomized controlled trial. Baseline and 3-month follow-up data were collected from 116 young adult smokers (mean age 21.8 years, SD = 2.1) who were randomized at a 2:1 ratio to receive a 6-week text messaging program focused on either smoking cessation (n = 72), or improving sleep and physical activity (n = 44). Three main outcomes were assessed: 1) sleep quantity (on work/school nights, and non-work/non-school nights), 2) sleep quality, and 3) physical activity at follow-up. Multivariable linear regression analysis was used to quantify the differences in these outcomes between the groups. To identify possible effect modification by baseline sleep and physical activity, the sample was stratified by indicators defined for both of these variables.ResultsAt follow-up, sleep quantity and quality were similar for participants in the smoking cessation and sleep/activity groups when assessed among the total sample and those sleeping ≥6 hours/night at baseline. Among short sleepers (<6 hours/night at baseline), sleep quantity on work/school nights improved for those receiving sleep/activity messages compared to those receiving smoking cessation messages, after adjusting for covariates ( =1.373, 95 % CI [0.262, 2.484]; p = 0.02). Physical activity at follow-up was similar for the two groups, when examined among the total sample and when stratified by baseline activity level.ConclusionsThis study provides preliminary evidence that a text message-based intervention may be a promising approach for improving sleep quantity among young adult smokers who are short sleepers and interested in quitting smoking. Similar programs should be further explored as a novel approach for improving sleep habits among individuals with insufficient sleep.Trial registrationClinicalTrials.gov NCT01516632

The SHS program can be delivered to groups of caregivers in community settings, is positively received by caregivers, and produces desirable changes that can be expected to improve caregivers' home safety practices.

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