A childhood obesity intervention developed by families for families: results from a pilot study

Abstract

BackgroundIneffective family interventions for the prevention of childhood obesity have, in part, been attributed to the challenges of reaching and engaging parents. With a particular focus on parent engagement, this study utilized community-based participatory research to develop and pilot test a family-centered intervention for low-income families with preschool-aged children enrolled in Head Start.MethodsDuring year 1 (2009–2010), parents played an active and equal role with the research team in planning and conducting a community assessment and using the results to design a family-centered childhood obesity intervention. During year 2 (2010–2011), parents played a leading role in implementing the intervention and worked with the research team to evaluate its results using a pre-post cohort design. Intervention components included: (1) revisions to letters sent home to families reporting child body mass index (BMI); (2) a communication campaign to raise parents’ awareness of their child’s weight status; (3) the integration of nutrition counseling into Head Start family engagement activities; and (4) a 6-week parent-led program to strengthen parents’ communication skills, conflict resolution, resource-related empowerment for healthy lifestyles, social networks, and media literacy. A total of 423 children ages 2–5 years, from five Head Start centers in upstate New York, and their families were exposed to the intervention and 154 families participated in its evaluation. Child outcome measures included BMI z-score, accelerometer-assessed physical activity, and dietary intake assessed using 24-hour recall. Parent outcomes included food-, physical activity- and media-related parenting practices and attitudes.ResultsCompared with pre intervention, children at post intervention exhibited significant improvements in their rate of obesity, light physical activity, daily TV viewing, and dietary intake (energy and macronutrient intake). Trends were observed for BMI z-score, sedentary activity and moderate activity. Parents at post intervention reported significantly greater self-efficacy to promote healthy eating in children and increased support for children’s physical activity. Dose effects were observed for most outcomes.ConclusionsEmpowering parents to play an equal role in intervention design and implementation is a promising approach to family-centered obesity prevention and merits further testing in a larger trial with a rigorous research design.

Effect of maternal health education on physical activity and body mass index of overweight children

“…Similarly, other studies suggest that health education for parents may lower children's energy intake. 19,25 Physical activity is a key determinant in energy expenditure, resulting in the basis for energy balance and body weight control. 26 Upon the completion of intervention, we observed a higher mean physical activity level in the treatment group than in the control group, suggesting that health education for mothers may have influenced the increase in children's physical activity.…”

“…18 Parents can provide healthy food and support their children's physical activity. 19 Parents, especially mothers, have a crucial social influence in the food choices made by their children. 7 Children generally copy their parents' diet and act submissively in accepting the dishes served to them.…”

Correlates of Resource Empowerment among Parents of Children with Overweight or Obesity

“…1 Prior research shows that this scale demonstrates high internal consistency (internal reliability score of a = 0.96) 1 and is sensitive to change. 20 Items (n = 5) assess parents' perceived knowledge of resources, ability to access resources, comfort with accessing resources, knowledge of how to find resources, and ability to acquire resources. For each question, parents responded strongly disagree, disagree, agree, or strongly agree, which were worth 1-4 points, respectively.…”

A systematic review on empowerment for healthy nutrition in health promotion

“…1). Table 1 provides an overview of the main characteristics of the eight included studies (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) . All studies were performed in Anglophone or Scandinavian countries within the last two decades.…”