Play & Grow: prospective observational cohort of toddlers to inform obesity prevention, Columbus, Ohio, USA

Abstract

PurposeObesity prevention is increasingly focused on early childhood, but toddlers have not been well-studied, and children born preterm are frequently excluded. The Play & Grow Cohort was established to investigate child growth in relation to parent-child interactions in mealtime and non-mealtime settings.ParticipantsBetween December 2017 and May 2019, 300 toddlers and primary caregivers were recruited from records of a large paediatric care provider in Columbus, Ohio, USA. This report describes recruitment of the cohort and outlines the data collection protocols for two toddler and two preschool-age visits. The first study visit coincided with enrolment and occurred when children (57% boys) were a mean (SD) calendar age of 18.2 (0.7) months.Findings to dateChildren in the cohort are diverse relative to gestational age at birth (16%, 28–31 completed weeks’ gestation; 21%, 32–36 weeks’ gestation; 63%, ≥37 weeks’ gestation) and race/ethnicity (8%, Hispanic; 35%, non-Hispanic black; 46%, non-Hispanic white). Caregivers enrolled in the cohort are primarily the child’s biological mother (93%) and are diverse in age (range 18–54 years), education (23%, high school or less; 20% graduate degree) and annual household income (27%, <US$20 000 24%, ≥US$90 000). Parent-child interactions were video-recorded during play in the laboratory at 18 months (n=299) and during play, reading and mealtime in the home (n=284) at 24 months. The preschool phase of the study was impacted by COVID-19. Parent-child interactions were video-recorded during play and mealtime at home at 36 months (n=141) and during a standardised buffet meal in the laboratory at 42 months (n=50). Caregivers unable to participate in face-to-face visits due to COVID-19 completed questionnaires.Future plansAssessment during middle childhood is being planned. Future visits will include anthropometric measurements and parent-child interactions at mealtime. School-based outcomes are additionally being considered.

Variability in parenting behaviours during play and during mealtimes with toddlers

“…We sought to explore variability in parenting behaviour as observed in interactions with toddlers during play and during a family mealtime to inform our prospective cohort study focused on childhood obesity prevention (Parrott et al, 2022). Limited published empirical evidence was available in which parent-child interactions in a family mealtime context were directly compared to those interactions as they are typically assessed in semi-structured play tasks.…”

“…We analysed data collected between December 2017 and May 2019 in the Play & Grow study. The design and recruitment of this cohort of 300 families with an 18‐month‐old child have been described (Parrott et al, 2022). A feature of the study was variation in gestational age with an enrolment target of 60% of children born full term (≥37 weeks).…”

“…We analysed data collected between December 2017 and May 2019 in the Play & Grow study. The design and recruitment of this cohort of 300 families with an 18-month-old child have been described (Parrott et al, 2022).…”

“…A further limitation of our study was the 6-month time lag between when the play interaction and mealtime interaction were conducted. Our protocol could not accommodate assessment of parent-child interaction in a food-related context at 18 months (Parrott et al, 2022). Prior research provides evidence that parenting is stable across early childhood (Mills-Koonce et al, 2015).…”

Factors associated with parenting stress in parents of 18‐month‐old children

“…This study analyses data collected during the first wave of an ongoing study, Play & Grow, a prospective cohort study focused on parent–child mealtime interactions (including children who were born preterm) in relation to child outcomes during the toddler to preschool‐age developmental period (Parrott et al, 2021). Briefly, parent–child dyads residing in central Ohio were recruited from a large, tertiary care academic paediatric medical centre between November 2017 and May 2019.…”