Childhood obesity has reached epidemic proportions and is considered to be a public health crisis in the United States. Increases in U.S. overweight and obesity prevalence have been most apparent for the preschool age group. Low-income and minority youth are at greater risk for obesity and therefore African American preschoolers are a critical population to target for intervention efforts. In spite of substantial literature pointingto the importance of early prevention efforts for childhood obesity and the need to focus on minority children who are at greatest risk, few prevention or intervention studies have targeted this population. The preschool years may be the most opportune and critical point in time for intervention strategies. Parents play a critical role in children's weight during this time period through shaping food and activity choices, as well as via specific parenting practices and modeling of behaviors and attitudes. Furthermore, the current literature and our experience suggest that parental attendance is a substantial barrier to program success. Therefore, successful interventions for this population need to increase access to services by providing interventions in the home. Therefore, the purpose of the present study is to develop and preliminarily validate a parent focused obesity intervention program for parents of low-income, African American preschoolers who are currently overweight. This proposed research will take place with an urban Head Start Agency. The proposed study includes a development phase and a pilot validation phase (clinical trial). In the first budget year, we propose to develop an intervention that is eight sessions in length that will be carried out in the participant's home. Te sessions will target the nutrition and physical activity knowledge of parents and their motivation for changing parenting related to family eating habits and activity level. Intervention content for the parent will be based on Motivational Interviewing (MI) principles. Although MI has been widely used to intervene with individual adults and adolescents, utilizing MI techniques to influence parenting behavior, especially parenting behavior related to health behavior change, is novel. In budget years 2 and 3, the pilot phase will include a sample of 76 parents recruited from the Head Start program, whose enrolled families are primarily African American. Parents will be randomly assigned to either the home-based prevention intervention or an attention control intervention. Pre, post, 6-month and 1-year follow-up data will be collected that includes BMI, parent nutrition and physical activity knowledge, motivation for health behavior change, parenting skills, child fruit and vegetable intake, intake of sugar-sweetened beverages, and activity levels. The current study will allow us to evaluate intervention feasibility and acceptabiity and estimate intervention effect sizes for a larger clinical trial. The long-term goal will be to identify best practices for reducing childhood overweight and obesity in an at-risk population.
Low-income and minority youth are disproportionately affected by obesity and therefore African American preschoolers are a critical population to target with intervention efforts. Addressing the nutrition and physical activity knowledge of parents and their motivation for changing parenting related to family eating habits and activity level with a home-based intervention may offer an early and promising opportunity to reduce health disparities. The development of an intervention that includes these components has the potential to significantly improve the weight trajectories of African American preschoolers.
