Approximately one quarter of children between the ages of 2 and 5 years are overweight or obese with higher rates among African American, Hispanic and low-income children. Certain risk factors for obesity in low- income children and their families include consumption of more convenience food than their higher income counterparts, higher intake of sugar sweetened beverages and lower diet quality scores for total vegetables, dark green and orange vegetables, legumes, and whole grains. When considering potential novel intervention targets for obesity prevention in low-income families, fathers are spending more time with their children than they have in the past and becoming much more involved in their children's lives. Similar to mothers, fathers have expressed difficulty and frustration with children being picky eaters, and report using undesirable feeding practices, such as bribing, to get their children to eat. Furthermore, because a father's weight may be a stronger predictor of a child's weight than a mother's weight, childhood obesity interventions may be unsuccessful if they only involve mothers and do not determine the unique influences of fathers. Therefore, the specific aims of the proposed research are to conduct a pilot feasibility trial with low-income father/child dyads to inform a future randomized controlled trial (RCT) including: a) Testing feasibility of recruitment/retention methods, intervention delivery, evaluation methods and measures; b) Comparing the DAD intervention with a wait-list control intervention to calculate effect sizes for outcomes including food- related parenting practices, mealtime behaviors and practices, and father/child nutrition and physical activity behaviors. Additional aims will explore the effectiveness of the DAD intervention on father/child diet quality and BMI/BMI z-score and the relationship between outcome measures and potential mediating variables. Father and child dyads (n=60) will enroll in an 8 session (2 hours/session) intervention (DAD) including nutrition and parent education with between-session technology enhancement outreach. Dyads will be randomly assigned within groups of 10 to DAD or a wait-list control group. Assessments will be conducted at pre, post and 1 month post including a subset of data from cohabiting mothers to assess moderating influences on outcomes. The proposed intervention will evaluate and explore the unique influences that low-income fathers have on their preschool age children's obesogenic behaviors and obesity risk. The innovation of combining nutrition and parent education while targeting a novel population, low income fathers, for childhood obesity prevention will provide evidence for future RCTs and programs to be implemented in the US especially for high risk families participating in federally funded nutrition assistance programs.
The increased risk of childhood obesity in low-income families remains a pressing public health issue. This study proposes a novel approach by targeting low income fathers in an intervention including nutrition and parenting education to improve obesogenic behaviors of their preschool age children.
