Parent-focused change to prevent obesity in preschoolers: Results from the KAN-DO study

Abstract

Objective Present the immediate post-intervention results of Kids and Adults Now - Defeat Obesity!, a randomized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler (2–5 years old) dyads in North Carolina (2007–2011). The outcomes include change from baseline in the child’s diet, physical activity and weight, and in the mother’s parenting behaviors, diet, physical activity, and weight. Method The intervention targeted parenting through maternal emotion regulation, home environment, feeding practices, and modeling of healthy behaviors. 400 Mother-child dyads were randomized. Results Mothers in the intervention arm, compared to the control arm, reduced instrumental feeding (−0.24 vs. 0.01, p<0.001) and TV snacks (−.069 vs. −0.24, p=0.001). There were also improvements in emotional feeding (p=0.03), mother’s sugary beverage (p=0.03) and fruit/vegetable (p=0.04) intake, and dinners eaten in front of TV (p=0.01); these differences were not significant after adjustment for multiple comparisons. Conclusion KAN-DO, designed to maximize the capacity of mothers as agents of change, improved several channels of maternal influence. There were no group differences in the primary outcomes, but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers’ diets. Long-term follow-up will address whether these short-term trends ultimately improve weight status.

A Positive Deviance Approach to Early Childhood Obesity: Cross-Sectional Characterization of Positive Outliers

“…Notably, one interventional study aimed at preventing early childhood obesity observed reductions in instrumental and emotional feeding practices. 36 Parents of normal weight children describing an internal reaction to their personal experiences as their motivation for behavioral change is a novel finding. However, this observational finding is essentially what the emerging literature on using motivational interviewing describes.…”

Motivational Interviewing to Prevent Childhood Obesity: A Cluster RCT

“…16,17 Despite promising results in the treatment of adult obesity, 18 MI as a counseling tool for the prevention or treatment of childhood obesity has shown only a weak or no effect in children and their parents. [19][20][21][22][23][24] Too brief an intervention or follow-up period, and possibly limited intervention fidelity, have been proposed as explanations for the lack of an intervention effect. There is, however, an exception in 1 recent study, which presents a modest effect of MI compared with care as usual, when targeting overweight and obese preschool children and their parents.…”

The impact of fruit and vegetable intake on weight management

“…Based on the inform a tion avail able, 10 studies were considered to have low risk of bias (Chen et al , 2010(Chen et al , , 2011Gow et al , 2010;Kennedy et al , 2009;Kim et al , 2010;LaChausse, 2012;Luszczynska and Haynes, 2009;Østbye et al , 2012;Rosenkranz et al , 2010;Zask et al , 2012), nine had moder ate risk (Bayer et al , 2009;De Bock et al , 2012;Gentile et al , 2009;Gephart and Loman, 2013;Haire-Joshu et al , 2008;Hoffman et al , 2011;NeumarkSztainer et al , 2009;Siegel et al , 2010;van Wier et al , 2009), and six had high risk (Branscum et al , 2013;Foster et al , 2008;French et al , 2010;Spiegel and Foulk, 2006;Taylor et al , 2007;Warren et al , 2003). Nine studies repor ted random iz a tion by a computer, random number tables, or permuted blocks.…”

“…Nineteen of 25 studies repor ted posit ive effects on increas ing fruit and/or veget able consump tion (Bayer et al , 2009;Branscum et al , 2013;Chen et al , 2010Chen et al , , 2011De Bock et al , 2012;French et al , 2010;Gentile et al , 2009;Gephart and Loman, 2013;Haire-Joshu et al , 2008;Hoffman et al , 2011;Kennedy et al , 2009;Kim et al , 2010;LaChausse, 2012;Luszczynska and Haynes, 2009;Østbye et al , 2012;Spiegel and Foulk, 2006;Taylor et al , 2007;Warren et al , 2003;Zask et al , 2012), while five revealed no FV effects (Gow et al , 2010;Neumark-Sztainer et al , 2009;Rosenkranz et al , 2010;Siegel et al , 2010;van Wier et al , 2009). One study detected decreased FV consump tion (Foster et al , 2008).…”

“…Of the 17 chil dren or adoles cent inter ven tions, 70.6% ( n = 12) repor ted posit ive effects on FV consump tion in chil dren (Bayer et al , 2009;Branscum et al , 2013;Chen et al , 2010;De Bock et al , 2012;Gentile et al , 2009;Gephart and Loman, 2013;Hoffman et al , 2011;Spiegel and Foulk, 2006;Taylor et al , 2007;Warren et al , 2003;Zask et al , 2012). Of the 14 inter ven tions with adults, 57.1% ( n = 8) repor ted posit ive effects in adults (French et al , 2010;Gentile et al , 2009;Haire-Joshu et al , 2008;Kennedy et al , 2009;Kim et al , 2010;LaChausse, 2012;Luszczynska and Haynes, 2009;Østbye et al , 2012).…”