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Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study.

ABSTRACT: The purpose of this study was to evaluate a theory-based, multicomponent eHealth intervention aimed at improving child health behaviors and parental psychosocial attributes and feeding practices. A pilot randomized controlled trial was conducted among 73 parents with children (1-3 years). Intervention group participants (IG, n = 37) received theory-based educational videos, cooking tutorials, and text messages with key information for a total of 8 weeks. Control group participants (CG, n = 36) received a booklet about general nutrition recommendations for children. A parent-administered questionnaire was used for data collection at baseline and post-intervention. Linear models were performed using R version 4.1.1. for data analysis. Children in the IG significantly increased their daily intake of fruit (ΔΔ = 0.89 servings, p = 0.00057) and vegetables (ΔΔ = 0.60 servings, p = 0.0037) and decreased use of screen time (ΔΔ = -33.87 min, p = 0.026), compared to the CG. Parents in the IG improved significantly more than the CG in self-efficacy (p = 0.0068) and comprehensive feeding practices (p = 0.0069). There were no significant differences between the study groups for changes in child outcomes, such as physical activity and sedentary behaviors, and parental nutrition knowledge and attitudes.

SUBMITTER: Lee H

PROVIDER: S-EPMC10222385 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study.

Lee Hyunjung H Oldewage-Theron Wilna W Dawson John A JA

Nutrients 20230513 10

The purpose of this study was to evaluate a theory-based, multicomponent eHealth intervention aimed at improving child health behaviors and parental psychosocial attributes and feeding practices. A pilot randomized controlled trial was conducted among 73 parents with children (1-3 years). Intervention group participants (IG, <i>n</i> = 37) received theory-based educational videos, cooking tutorials, and text messages with key information for a total of 8 weeks. Control group participants (CG, <i ...[more]

PMID: 37242179

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Project description:BackgroundBehaviour change science is proposed to improve participant retention and enhance the validity of trials. However, researchers seldom systematically consider and implement behaviour change strategies within trials for this purpose. The objective of this article is to evaluate how an eHealth behaviour change support (BCS) program enhances young adults' adherence to behaviours required within a dietary intervention.MethodsThe Nine Principles framework was used to develop BCS to implement across both arms of a 10-week randomised parallel-group intervention to enhance adherence to (i) eating healthily and (ii) reporting dietary intake. Key components of the BCS included access to a dietitian-led Facebook group, text reminders, and food delivery. Effectiveness was measured using the following analyses of the 78 participants who completed the study; pre-post change in targeted dietary habits over time using a subscore of the Healthy Diet Habits Index, questionnaire to assess change in perception of barriers to eating healthily over time, Facebook group engagement, and impact evaluation of the BCS. Participants received a dietary reporting score out of 100 to assess adherence across the 10 weeks.ResultsThe total Healthy Diet Habits Index subscore out of 16 significantly increased from baseline to week 10 (10.6 ± 2.6 to 11.2 ± 2.6, p value < 0.05), driven primarily by an increase in vegetable consumption. Overall adherence to reporting was high across the 10 weeks, with the total population mean reporting score 90.4 ± 14.6 out of 100. Relatively low Facebook engagement was observed. Adding objects to the environment, prompts/cues and removing reward appeared to be effective components of the BCS for enhancing adherence to the target behaviours.ConclusionUsing a behaviour change framework to support the design of randomised trials is a promising way to enhance participant adherence to study requirements that are typically considered burdensome, such as dietary reporting. It also enables researchers to identify and replicate effective components of BCS, including behaviour change techniques and modes of delivery. Further research into the use of different behaviour change frameworks for this purpose is warranted.Trial registrationClinicalTrials.gov Identifier: NCT04869163; https://clinicaltrials.gov/ct2/show/NCT04869163 . (03/05/2021).

Project description:BACKGROUND:Little research has targeted multiple-level barriers and facilitators in school-based parental support programmes. This qualitative study aims to describe barriers and facilitators, at organisational and personal levels, that teachers and parents in disadvantaged settings in Sweden perceived as influencing the implementation of the Healthy School Start II (HSS II) intervention. METHODS:Data collection, analysis and interpretation were guided by the Consolidated Framework for Implementation Research (CFIR). Focus groups and interviews were conducted with 14 parents and ten teachers within the HSS II trial. Data were analysed using qualitative content analysis in a deductive step using the three CFIR domains-inner and outer setting, and personal characteristics-followed by an inductive analysis. RESULTS:The theme 'being on the same page-getting burdened teachers and parents to work on common ground' was found. Among teachers, barriers and facilitators were related to the structure of the schoolwork and curriculum, involvement from other staff and school management, the practical school workday, perception of high family needs but low parental interest, insufficient resources in the families, and teacher's personal knowledge, interests, and opinions about health and food. For parents, barriers and facilitators were related to the perceived family needs and resources, parents' health knowledge, consensus about healthy behaviours and ability to cooperate, and school involvement in health issues and the intervention. CONCLUSION:Interventions should facilitate parents' and teachers' work on common ground, with activities suitable for a stressful and burdensome workday and everyday life. This could be achieved by integrating evidence-based practices within school routines, and including activities that are practicable despite parents' stressful lives, and that increase parental consensus about promoting health. Strategies to increase involvement of parents in families with high needs are necessary. Also, this study suggests an expansion of the CFIR to capture the interface between different micro-level organisations, and account for several delivering/receiving organisations.

Project description:Abstract Objectives The objective of this study was to evaluate a parent-focused eHealth intervention aimed at improving fruit and vegetable intake and active play among toddlers in West Texas. Methods A randomized controlled trial was conducted among 73 parents with toddlers between August and December 2021. Intervention group participants (n = 37) completed weekly videos and biweekly online cooking activities through the Healthy Online Parental Education (HOPE) website for a total of 8 weeks. The HOPE intervention curriculum was informed by the Social Cognitive Theory. Control group participants (n = 36) received printed materials about dietary recommendations for children. The primary outcomes were fruit and vegetable intake and physical activity among children. Secondarily, parents completed an assessment in nutritional knowledge, self-efficacy, and feeding practices. There were two data collection points at baseline and post-intervention. A linear mixed model was performed to compare intervention with control group effects over time on study outcomes. Results More than half of the children were male (56%) with a mean age of 27 months. Children in the intervention group showed a small but significant increase in vegetable intake by 0.75 servings (P < 0.05) than in the control group. There was a significant increase in active playtime by 19.88 minutes in the intervention group (P < 0.05). Parents in the intervention group significantly increased their scores in nutritional knowledge (p = 0.01), self-efficacy around feeding (p = 0.02), and healthy modeling practices (P < 0.05) at post-intervention. There was no significant difference in child fruit intake between the intervention and control group at post-intervention. Conclusions The HOPE program was successful in improving vegetable intake and active playtime among toddlers, but not fruit intake at post-intervention. Parent-focused eHealth interventions may have the potential to address child health disparities in areas where the communities are underserved. The HOPE trial was registered at clinicaltrials.gov as NCT05085041. Funding Sources This study was partially funded by the Graduate School at Texas Tech University.

Project description:BackgroundMothers in Motion (MIM), a community-based intervention program, was designed to help young, low-income women with overweight or obesity prevent further weight gain by promoting stress management, healthy eating, and physical activity. This paper presents the MIM's intervention effect on self-efficacy to cope with stress, emotional coping response, social support for stress management, stress, depressive symptoms, and positive and negative affect.MethodsParticipants (N = 612) were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan. They were randomly assigned to an intervention group (410 participants) or comparison group (202 participants). During the 16-week intervention, intervention participants watched ten video lessons at home and joined ten peer support group teleconferences. Surveys with established validity and reliability were used to measure self-efficacy to cope with stress, emotional coping response, and social support for stress management. The Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and Positive and Negative Affect Scale were used to measure stress, depressive symptoms, and positive and negative affect, respectively. A general linear mixed model was applied to test the intervention effect at the end of the 16-week intervention (T2, n = 338) and at three-month follow-up (T3, n = 311).ResultsAt T2, the intervention group reported significantly higher self-efficacy to cope with stress (effect size [Cohen's d] = 0.53), better emotional coping response (d = 0.38), less stress (d = 0.34), fewer depressive symptoms (d = - 0.27), and more positive affect (d = 0.31) than the comparison group. However, there were no significant differences in social support for stress management and negative affect between these two groups. At T3, the intervention group still reported significantly higher self-efficacy to cope with stress (d = 0.32) and better emotional coping response (d = 0.34) than the comparison group but did not report significantly higher social support for stress management, stress, depressive symptoms, and positive and negative affect.ConclusionsTo help young, low-income women with overweight or obesity manage stress, researchers and program planners may consider focusing on building self-efficacy to cope with stress.Trial registrationClinical Trials NCT01839708 ; registered February 28, 2013.

Dataset Information

Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study.

Publications

Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study.

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