The early years between ages 3 -7 have been described as a critical period in the development of obesity. The importance of the family on the development of eating and physical activity behaviors in young children has been emphasized by experts, yet to date no obesity prevention interventions incorporating a strong family focus with emphasis on improved parenting practices have been developed. The work proposed here will address this gap by testing the efficacy of a 12-mo parent-focused intervention designed to change multiple aspects of children's home environments (both social and physical), which in turn will reduced percent body fat (%BF) in children. Subjects will be 280 parent-child pairs recruited through child care settings that cater to lower income families. Following baseline measures, pairs will be randomized into intervention or control. The intervention will first focus on teaching more effective parenting skills (time management, communication, etc.);then showing how specific parenting practices can influence a child's physical and social environment and encourage healthier behaviors. The intervention will be delivered through group sessions and home-based telephone calls (group chats and tailored calls) facilitated by a certified parent educator. Group sessions will use multiple teaching strategies such as "Parentela Novellas" (soap opera-like videos which provides models for skills practice). Sessions will also provide separate child activities that build off the coercion hypothesis and prepare children to receive new parenting practices. Group phone chats will build peer support among parents and tailored counseling calls will use motivational interviewing techniques to help parents overcome barriers to implementing new behaviors. The intervention is guided by Darling and Steinberg's Integrative Model of parenting (1993) which highlights the importance of parenting values, style and practices in child socialization. In addition, Self-Determination Theory (Ryan, 2000) is used to create a program that fosters parents'autonomous motivation to adopt new parenting style and practices. The result is a intervention that will help parents learn skills to reduce their parenting-related stress and create a home environment that supports the development of healthy-weight behaviors. The primary outcome, %BF in children, will be assessed using anthropometry and a validated prediction equation (Denzenberg, 1999). Analyses will include baseline measurements of the outcome as a covariate. Secondary measures include child and mother diet and physical activity, parenting style and practices, parenting stress, and home environment. Maintenance of intervention effect will be assessed following a 12-mo no-intervention period. This intervention will create the intensive exposure necessary to make life-altering changes in parent and child behavior that will result in reduced body fat. Plans are based on extensive formative work, and the research will be lead by a group of very experienced investigators.

Public Health Relevance

Efforts are needed to assure that young children develop healthy eating and physical activity behaviors for healthy weight development. Parent behavior affects both the social and physical home environment, creating the context within which these behaviors develop. Few programs exist to prevent obesity and fewer still have used a family-focused approach. This application describes an innovative, theory-driven intervention designed to help parents implement more effective parenting behaviors and reduce their parenting-related stress, while also creating a home environment that supports the development of healthy weight practices in their preschool children.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL091093-04
Application #
8123131
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Pratt, Charlotte
Project Start
2008-09-15
Project End
2013-12-31
Budget Start
2012-01-01
Budget End
2013-12-31
Support Year
4
Fiscal Year
2012
Total Cost
$690,523
Indirect Cost
$220,226
Name
University of North Carolina Chapel Hill
Department
Nutrition
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Jones, Deborah J; Gonzalez, Michelle; Ward, Dianne S et al. (2014) Should child obesity be an issue for child protective services? A call for more research on this critical public health issue. Trauma Violence Abuse 15:113-25
Vaughn, Amber E; Tabak, Rachel G; Bryant, Maria J et al. (2013) Measuring parent food practices: a systematic review of existing measures and examination of instruments. Int J Behav Nutr Phys Act 10:61
Vaughn, Amber E; Hales, Derek; Ward, Dianne S (2013) Measuring the physical activity practices used by parents of preschool children. Med Sci Sports Exerc 45:2369-77
Hales, Derek; Vaughn, Amber E; Mazzucca, Stephanie et al. (2013) Development of HomeSTEAD's physical activity and screen time physical environment inventory. Int J Behav Nutr Phys Act 10:132
Ward, Dianne S; Vaughn, Amber E; Bangdiwala, Kant I et al. (2011) Integrating a family-focused approach into child obesity prevention: rationale and design for the My Parenting SOS study randomized control trial. BMC Public Health 11:431