Pediatric overweight is a national public health concern. The percentage of overweight children in the U.S. between the ages of 6 and 11 has nearly tripled in the last 3 decades and African Americans are particularly at risk. Moreover, pediatric overweight is associated with numerous physical and psychological health problems and overweight children are at significant risk for obesity in adulthood. Despite the urgent need for pediatric overweight interventions, outcomes of some of the most rigorous treatments are, at best, mixed. Although research has found that including parents in interventions for pediatric overweight has positive effects on outcomes, relatively few studies have included sufficient numbers of lower-SES, African American participants, a group at increased risk for pediatric overweight and associated complications. Further, although parental involvement in treatment for pediatric overweight is beneficial, few studies have examined the efficacy of offering treatment exclusively to parents, a potentially cost- effective approach which could benefit the entire family This study will evaluate the efficacy of an intensive intervention targeting ethnically diverse parents of overweight (BMI >85th percentile) children ages 5-11. This intervention has been implemented in a small pilot trial (R03 HD056050, NOURISH-Nourishing Our Understanding of Role modeling to Improve Support and Health), and yielded significant reductions in child BMI percentile. In this R01 application, we propose a larger RCT of NOURISH (NOURISH+), which will build upon the strengths of our pilot work and integrate more hands-on experiences for parents to optimize the intervention's efficacy. Parents meeting study criteria will be offered participation in the randomized trial comparing NOURISH+ with a control group. We hypothesize that children whose parents participate in NOURISH+ will manifest greater decreases in BMI percentile, and greater improvements in dietary intake, physical activity, and quality of life compared to children whose parents are in the control group. Results have significant potential to inform future translational studies involving NOURISH+.

Public Health Relevance

The percentage of overweight children ages 6 to 11 has nearly tripled in the last three decades, and rates are even higher among African Americans. Overweight children are at-risk for numerous physical and mental health problems, thus effective treatments are urgently needed. This study will evaluate an innovative, intervention for ethnically diverse parents (NOURISH+), which focuses on helping parents role model and teach their children healthy behaviors.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Psychosocial Risk and Disease Prevention Study Section (PRDP)
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Esposito, Layla E
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Virginia Commonwealth University
Schools of Arts and Sciences
United States
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Lydecker, Janet A; Simpson, Courtney; Kwitowski, Melissa et al. (2017) Evaluation of Parent-Reported Feeding Practices in a Racially Diverse, Treatment-Seeking Child Overweight/Obesity Sample. Child Health Care 46:265-281
Kwitowski, Melissa; Bean, Melanie K; Mazzeo, Suzanne E (2017) An exploration of factors influencing attrition from a pediatric weight management intervention. Obes Res Clin Pract 11:233-240
Bean, Melanie K; Jeffers, Amy J; Tully, Carrie B et al. (2014) Motivational interviewing with parents of overweight children: study design and methods for the NOURISH + MI study. Contemp Clin Trials 37:312-21