Parents and Tots Together: Pilot randomized controlled trial of a family-based obesity prevention intervention in Canada

Abstract

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.

Impact of Parent Engagement in Childhood Obesity Prevention Interventions on Anthropometric Indices among Preschool Children: A Systematic Review

“…Most of studies focused mainly on children outcomes, while some others evaluated parental measures as well. 24,26,28,30,34,36,38,[40][41][42] A number of studies have exclusively selected the overweight or obese children and their parents for intervention, 21,24,25,29,30,32,[35][36][37]39,40,43 and the rest have targeted all children, regardless of their current weight or BMI. Seven out of 12 studies that targeted overweight or obese children in their intervention resulted in higher improvement in outcomes (especially anthropometric outcomes).…”

“…Among those studies that had a follow-up component, it ranged between 6 weeks 41 and 12 months. 24,27,32,36 Duration of intervention was less than 6 months in most of the studies, [19][20][21][22][23][25][26][27][28][29][30][31][32]34,[36][37][38][41][42][43] and only six studies had intervention duration of 12 months or more. 24,33,35,39,40,44 Improvement in anthropometric indices was seen in 3 out of 6 studies with intervention period of 12 months and more.…”

Parents Working Together: development and feasibility trial of a workplace-based program for parents that incorporates general parenting and health behaviour messages

“…PTT is guided by the social contextual framework and embeds weight-related behaviour messaging within a general parenting program to be delivered to parents of children ages 2–5 years [18]. Results from a feasibility trial of PTT in community-based settings in Canada show that PTT was well received by parents (100 % of participants reported being either satisfied or very satisfied with the program) [19]. Additionally, compared to those in the control, parents who received the PTT intervention reported using food as a reward less frequently at post-intervention (β = -0.50, 95 % CI -0.90, -0.11, p  = 0.01).…”

“…Additionally, compared to those in the control, parents who received the PTT intervention reported using food as a reward less frequently at post-intervention (β = -0.50, 95 % CI -0.90, -0.11, p  = 0.01). Parents in the intervention also reported less parental stress (β = -20.67, 95 % CI -31.67, -9.62, p  = 0.001) and greater confidence in managing children’s behaviour (β = 0.32, 95 % CI 0.04, 0.61, p  = 0.03) compared to those in the control arm [19]. Other interventions using this approach have also found improvements in parental feeding practices [20, 22], as well as general parenting [21, 23].…”

Putting family into family-based obesity prevention: enhancing participant engagement through a novel integrated knowledge translation strategy

“…iKT is an approach to research that involves knowledge users as equal partners alongside researchers, with the goal of creating more relevant and useful interventions and better research outcomes [ 8 , 9 ]. While parents (usually mothers) have often been consulted during the planning stages of interventions through focus groups [ 10 ], this engagement rarely continues during implementation or evaluations stages of the research [ 4 , 5 ]. Parents provide an important “lived experience” perspective that lends well to understanding both the family and participant experience firsthand; iKT approaches provide space to reframe and refresh what is traditionally considered “expertise” [ 11 ].…”