Putting family into family-based obesity prevention: enhancing participant engagement through a novel integrated knowledge translation strategy.

BACKGROUND: With 1 in 4 Canadian preschoolers considered overweight or obese, identifying risk factors for excess weight gain and developing effective interventions aimed at promoting healthy weights and related behaviours among young children have become key public health priorities. Despite the need for this research, engaging and maintaining participation is a critical challenge for long-term, family-based studies. The aim of this study is to describe the implementation and evaluation of a parent-only advisory council designed to engage participants in the implementation and evaluation of a longitudinal, family-based obesity prevention intervention. METHODS: A Family Advisory Council (n = 14 parents, 70% mothers, 64% white), was established to engage participant stakeholders in decisions related to research protocols and strategies to engage and sustain family participation. Using a mixed methods approach, including a participant survey and focus group, we examined the council members' perceptions of their role and the impact this novel integrated Knowledge Translation (iKT) strategy had on the Guelph Family Health Study (GFHS), a longitudinal family-based study. RESULTS: All members of the Family Advisory Council felt the topics discussed were appropriate, felt that their opinions were valued and that their suggestions have had an impact and direct benefit on the GFHS. The addition of the Family Advisory Council led to changes in study protocol (i.e. creation of more detailed intervention emails, creation of kid-friendly accelerometer bands) that may have contributed to the high retention rate of the GFHS (95% at 6-month follow-up). CONCLUSIONS: Engaging parents as research partners in family-based research studies may be an effective way to increase participant engagement and study retention.

Stress is Associated with Adiposity in Parents of Young Children.

OBJECTIVE: This study investigated associations between stress (general stress, parenting distress, and household chaos) and adiposity among parents of young children. METHODS: The sample consisted of 49 mothers and 61 fathers from 70 families with young children living in Ontario, Canada. Linear regression using generalized estimating equations was used to investigate associations between stress measures and BMI, waist circumference (WC), waist to height ratio (WHtR), and percent fat mass. RESULTS: General stress was significantly associated with BMI ( ß ^ = 0.54; 95% CI: 0.04-1.03) and WC ( ß ^ = 1.44; 95% CI: 0.10-2.77). Parenting distress was significantly associated with BMI ( ß ^ = 0.16; 95% CI: 0.02-0.31), WC ( ß ^ = 0.39; 95% CI: 0.04-0.75), and WHtR ( ß ^ = 0.003; 95% CI: 0.001-0.005). Household chaos was significantly associated with all adiposity measures (BMI: ß ^ = 0.20 [95% CI: 0.08-0.33]; WC: ß ^ = 0.48 [95% CI: 0.21-0.75]; WHtR: ß ^ = 0.003 [95% CI: 0.001-0.005]; percent fat mass: ß ^ = 0.29 [95% CI: 0.08-0.49]). CONCLUSIONS: General stress, parenting distress, and household chaos are associated with adiposity among parents of young children. Future research should elucidate mechanisms by which this occurs and elucidate how this risk may be mitigated.

A randomized home-based childhood obesity prevention pilot intervention has favourable effects on parental body composition: preliminary evidence from the Guelph Family Health Study.

BACKGROUND: Home-based lifestyle behaviour interventions show promise for treating and preventing childhood obesity. According to family theories, engaging the entire family unit, including parents, to change their family behaviour and dynamics may be necessary to prevent the development of childhood obesity. However, little is known about how these interventions, which may change the family dynamics and weight-related behaviours of parents, affect weight outcomes in parents. Our objective was to examine the effect of a pilot home-based childhood obesity prevention intervention on measures of anthropometrics and body composition in Canadian parents. METHODS: Forty-four families with children aged 1.5-5 years were randomized to one of three groups: 4 home visits with a health educator, emails, and mailed incentives (4 HV); 2 home visits, emails, and mailed incentives (2 HV); or general health emails (control). Both the 2 HV and 4 HV intervention were conducted over a period of 6 months. Body composition and anthropometric outcomes were measured at baseline and at 6 months and 18 months from baseline. RESULTS: In parents with baseline body mass index (BMI) ≥ 25 kg/m2, the 2 HV group had significantly lower body mass and waist circumference at 6-month (CI = -5.85,-0.14 kg;-5.82,-0.30 respectively) and 18-month follow-up (CI = -7.57,-1.21 kg;-9.30,-2.50 cm respectively) when compared to control, and significantly lower BMI at 18-month follow-up when compared to control (CI = -2.59,-0.29 kg/m2). In parents with baseline BMI < 25 kg/m2, the 4 HV group had significantly lower percentage fat mass (CI = -3.94,-0.12%), while the 2 HV group had significantly lower body mass (CI = -2.56,-0.42 kg) and BMI (CI = -0.77,-0.08 kg/m2) at 6-month follow-up, both compared to control; these effects were not maintained at 18-month follow-up. CONCLUSIONS: This study provides support that a home-based childhood obesity prevention intervention may improve weight outcomes among parents. Future research should explore how home-based interventions influence family behaviour and dynamics to impact weight outcomes in children and their parents. TRIAL REGISTRATION: Prospectively registered August 2014, clinical trial identifier NCT02223234.