Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention (Preprint)

Abstract

BACKGROUND The Early Intervention Program (EIP) was a 10-week blended in-person and online lifestyle intervention for families with children who were off the healthy weight trajectory. The engagement pattern and the dose-response of EIP have not been examined. OBJECTIVE 1) To examine families' engagement patterns with the EIP; 2) To evaluate the dose-response relationship between EIP engagement patterns and physical activity and healthy eating-related outcomes at 10-weeks. METHODS Families with children who are off the healthy weight trajectory (child BMI ≥ 85th percentile for age and sex) were recruited. Pre-and post-intervention questionnaires assessed child lifestyle behaviours, parental support behaviours, family lifestyle habits and parental physical activity and healthy eating identity. Hierarchical cluster analysis of both in-person and online components was used to classify engagement patterns. Regression analysis assessed differences in outcomes by engagement groups. RESULTS Two distinct clusters of engagement groups were identified: in-person (IP, n=40) and in-person + online (IP+, n=26) engagement. Relative to the IP group at week 10, IP+ showed a greater child moderate-to-vigorous physical activity level (1.53 ±0.56, p=.008), child physical activity confidence (1.04 ±0.37, p=.007), parental support for child physical activity (5.54 ±2.57, p=.035) and healthy eating (2.43 ±1.16, p=.041), family habits for physical activity (3.02 ±1.50, p=.049) and healthy eating (3.95 ±1.84, p=.036), and parental identity for physical activity (2.82 ±1.19, p=.021). CONCLUSIONS The online EIP portal complemented the in-person sessions. Additional engagement with the portal was associated with greater improvements in child physical activity and parental support behaviours, habits, and identity. CLINICALTRIAL n/a