Objectives:
To evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviors (acquisition, preparation, and fruit and vegetable (FV) consumption) on youths’ primary caregivers.
Design:
B’more Healthy Communities for Kids (BHCK), group-randomized, controlled trial, promoted access to healthy food and food-related behaviors through wholesaler and small store strategies, peer-mentor led nutrition education aimed at youth, and social media and text messaging targeting their adult caregivers. Measures included caregivers’ (n=516) self-reported household food acquisition frequency for FV, snacks, and grocery items over 30 days, and usual consumption of FV in a sub-sample of 226 caregivers via the NCI FV Screener. Hierarchical models assessed average-treatment-effects (ATE). Treatment-on-the-treated-effect (TTE) analyses evaluated the correlation between behavioral change and exposure to BHCK. Exposure scores at post-assessment were based on self-reported viewing of BHCK materials and participating in activities.
Setting:
30 Baltimore City low-income neighborhoods
Subjects:
Adult caregivers of youth ages 9–15 years.
Results:
90.89% of caregivers were female, average 39.31(± 9.31) years. Baseline mean fruit intake (servings/day) was 1.30(± 1.69) and vegetable was 1.35(± 1.05). In ATE, no significant effect of the intervention was found on caregiver food-related behaviors. In TTE, for each point increase in the BHCK exposure score (range 0–6.9), caregivers increased daily consumption of fruits by 0.2 servings (0.24± 0.11; 95%CI 0.04; 0.47). Caregivers reporting greater exposure to social media tripled their daily fruit intake (3.16± 0.92; 95%CI 1.33; 4.99) and increased frequency of unhealthy food purchasing, compared to baseline.
Conclusions:
Child-focused community-based nutrition interventions may also benefit family members’ fruit intake. Child-focused interventions should involve adult caregivers and intervention effects on family members should be assessed. Future multilevel studies should consider using social media to improve reach and engage caregiver participants.