Pediatric obesity is difficult to treat, particularly if the parents also have weight problems and lifestyle habits that are less than healthy. This study shows that an in-home weight management program improves the health of not only the child, but also the child’s parents, according to a study published in the Journal of Nutrition Education and Behavior. Today’s Practitioner contacted the lead researcher to get more information on this important study.
Obese children are four times more likely to become obese adults making childhood obesity a significant health threat. “Parents typically are the most important and influential people in a child’s environment,” said authors Keely Hawkins, PhD, and Corby K. Martin, PhD, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA. “Adding this weight management strategy to existing state and federal home visitation programs could help address the current childhood obesity crisis.”
Home-based Weight Management Program Benefits both Children and Parents
Sixteen families participated in the study and were recruited from the community based on the child’s obesity risk. Children 2-6 years of age with a body mass index greater than the 75th percentile enrolled.This study used a program called, Developing Relationships that Include Values of Eating and Exercise (DRIVE). Families were randomly assigned to receive health information only or the DRIVE intervention.
The DRIVE curriculum was provided during 15 in-person sessions in the family’s home. Sessions were
30 minutes long, during which parents and children practiced healthy daily routines including establishing regular snack and mealtimes, reducing screen time, and encouraging physically active play. Each session focused on a single health topic such as portion size, food preparation, how to discuss weight and growth concerns with the pediatrician, and effective parenting strategies.
The group that did not receive in-home visits was mailed information on nutrition, physical activity, and parent-child interaction at the beginning of the study. “The information used to design the intervention and the materials sent to the homes of the control participants were based on similar references as they both use nutrition and physical activity guidelines from the USDA and CDC,” said Dr. Hawkins. “Additionally, families in the control group were provided with the free publication “Adventures in Parenting: How Responding, Preventing, Monitoring, Mentoring, and Modeling Can Help You Be a Successful Parent” provided by The National Institute of Child Health, Human Development. Information covered in this document includes effective parenting strategies for children at specific ages. Similarly, the intervention relied on principles of social learning theory, but the intervention materials could be customized by the interventionist based on the family’s need when it was delivered.”
Results / Children in the DRIVE intervention maintained their body weight with a modest reduction in body mass index over the 19 weeks of the study, while the children who received health education significantly increased their body weight and body mass index. Additionally, parents who participated in the DRIVE sessions also decreased their body weight.
Did the human interaction play a role in the success of the program? Yes, the authors believe it was the intensity and personalization of the intervention that made this so successful. “If the lesson was talking about snacks, the interventionist could walk to the pantry with them and help them decide what snacks are best and what shouldn’t be kept around. Similarly, if the lesson was talking about exercise and the interventionist can see that screen time could be an issue, they can specifically address those behaviors with the parent who can instill more positive behaviors in the child,” said Dr. Hawkins.
The study also reported that all 16 families completed the program. This level of participation is much higher than programs delivered through clinics or community programs, which can see as many as 75 percent of attendees leave the classes. “Retention and attendance is usually a huge issue with many traditional interventions, but since we were scheduling these intervention in their homes and on their time, we were able to have 100% attendance and retention which greatly increased the effectiveness of the intervention,” said Dr. Hawkins.
Dr. Hawkins and Dr. Martin shared, “Our results showed that at the half-way point of the study, children were becoming healthier. Changes in the health of the parents, though, did not happen until the end of the study. Because the intervention was geared toward children, the interventionists worked with the parents to instill the necessary positive lifestyle behaviors in the child. “The authors believe that the parents began to instill these positive lifestyle behaviors in their children first but then began applying the tools they learned through the intervention to themselves resulting in weight loss in the parents by the end of the study,” said Dr. Hawkins.
Conclusion / The DRIVE program mitigated weight gain in a small sample of at-risk children and showed promising results in reducing weight in parents. Home-based interventions emphasizing parent–child interactions are indicated as a practical model to deliver weight management in children.
“Efficacy of a Home-Based Parent Training-Focused Weight Management Intervention for Preschool Children: The DRIVE Randomized Controlled Pilot Trial,” by Keely R. Hawkins. PhD; John W. Apolzan, PhD; Amanda E. Staiano, PhD; Jenelle R. Shanley, PhD; and Corby K. Martin, PhD (https://doi.org/10.1016/j.jneb.2019.04.002). It appears in the Journal of Nutrition Education and Behavior, volume 51, issue 6 (June 2019) published by Elsevier.