Twelve-Month Efficacy of an Obesity Prevention Program Targeting Hispanic Families With Preschoolers From Low-Income Backgrounds.

OBJECTIVE: Assess effects of an obesity prevention program promoting eating self-regulation and healthy preferences in Hispanic preschool children. DESIGN: Randomized controlled trial with pretest, posttest, 6- and 12-month assessments. Fourteen waves, each lasting 7 weeks. SETTING: Families recruited from Head Start across 2 sites. PARTICIPANTS: Two hundred fifty-five families randomized into prevention (n = 136) or control (n = 119). INTERVENTION: Prevention received curriculum; control received no curriculum. MAIN OUTCOME MEASURE(S): Feeding knowledge/practices/styles (parent); body mass index percentile, eating self-regulation, trying new foods, and fruit/vegetable consumption (child). ANALYSIS: Multilevel analyses for nested data (time points within families; families within waves) and multinomial regression. RESULTS: Program increased mothers' repeated presentation of new foods (P < 0.05), measured portion sizes (P < 0.05), child involvement in food preparation (P < 0.001), feeding responsiveness (P < 0.001), knowledge of best feeding practices (P < 0.001), and feeding efficacy (P < 0.05); reduced feeding misconceptions (P < 0.01) and uninvolved feeding (P < 0.01). Effects on child eating behavior were minimal. At 12 months, children in the prevention group were less likely to have overweight (P < 0.05) or obesity (P < 0.05). CONCLUSIONS AND IMPLICATIONS: Program effects emphasize the importance of feeding approaches in reducing childhood obesity.

Short-Term Effects of an Obesity Prevention Program Among Low-Income Hispanic Families With Preschoolers.

OBJECTIVE: To assess the short-term effects of an obesity prevention program promoting eating self-regulation and healthy food preferences in low-income Hispanic children. DESIGN: Randomized controlled trial with pretest, posttest, and 6- and 12-month assessments. SETTING AND PARTICIPANTS: Head Start and similar early learning institutions in Houston, TX, and Pasco, WA. A total of 255 families with preschoolers randomized into prevention (n = 136) and control (n = 119) groups. INTERVENTION: Multicomponent family-based prevention program. Fourteen waves lasted 7 weeks each with 8-10 mother-child dyads in each group. MAIN OUTCOME MEASURES: Parent assessments included feeding practices, styles, and knowledge. Child assessments included child eating self-regulation, willingness to try new foods, and parent report of child fruit and vegetable preferences. Parent and child heights and weights were measured. ANALYSIS: Multilevel analyses were employed to consider the nested nature of the data: time points within families within waves. RESULTS: The program had predicted effects on parental feeding practices, styles, and knowledge in the pre- to post-comparisons. Effects on child eating behavior were minimal; only the number of different vegetables tried showed significant pre-post differences. CONCLUSIONS AND IMPLICATIONS: Short-term effects of this prevention program highlight the importance of family-focused feeding approaches to combating child overweight and obesity.

Strategies for Effective Eating Development-SEEDS: Design of an Obesity Prevention Program to Promote Healthy Food Preferences and Eating Self-Regulation in Children From Low-Income Families.

OBJECTIVE: To develop a scientifically based childhood obesity prevention program supporting child eating self-regulation and taste preferences. This article describes the research methods for the Strategies for Effective Eating Development program. A logic model is provided that depicts a visual presentation of the activities that will be used to guide the development of the prevention program. DESIGN: Randomized, controlled prevention program, pretest, posttest, 6 months, and 12 months. SETTING: Two sites: Houston, TX and Pasco, WA. Each trial will last 7 weeks with 8-10 mother-child dyads in each arm (prevention and control). PARTICIPANTS: Recruitment at Head Start districts (Texas; n = 160) and Inspire Child Development Center including Early Childhood Education and Head Start (Washington; n = 160). Sixteen trials with 16-20 parent-child dyads per trial will provide adequate power to detect moderate effects. INTERVENTION: Multicomponent family-based prevention program incorporating a dialogue approach to adult learning and self-determination theory. MAIN OUTCOME MEASURES: Child assessments will include observed taste preferences, caloric compensation, and eating in the absence of hunger. Parent assessments will include parent-reported feeding, feeding emotions, acculturation, child eating behaviors, child food preferences, and child dietary intake. Heights and weights will be measured for parent and child. ANALYSIS: A multilevel growth modeling analysis will be employed to consider the nested nature of the data: time points (level 1) within families (level 2) within trials (level 3).