A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study

BMC Public Health

Kristina Thorngren-Jerneck³  Christina Helgason¹  Malin Broberg²  Kristina Orban⁴  Lena-Karin Erlandsson⁴  Jenny Önnerfält³ 

[1] Department of Psycholog, Lund University, Lund, Sweden;Department of Psychology, University of Gothenburg, Gothenburg, Sweden;Department of Paediatrics; Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, SE, 221 85, Sweden;Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden

关键词: Intervention study;    Parent;    Child;    Preschool;    Obesity;    Overweight;   

Others  :  1162963
DOI  :  10.1186/1471-2458-12-879

 received in 2012-08-30, accepted in 2012-10-09,  发布年份 2012

【 摘 要 】

Background

As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score.

Methods/Design

The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress.

Discussion

The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity.

Trial registration

ClinicalTrials.gov NCT00916318

【 授权许可】

   
2012 Önnerfält et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Obesity: preventing and managing the global epidemic. Report of a WHO consultation World Health Organ Tech Rep Ser 2000, 894:1-253. i-xii
• [2]Mårild S, Bondestam M, Bergström R, Ehnberg S, Hollsing A, Albertsson-Wikland K: Prevalence of obesity and overweight among 10-year-old children in western Sweden and relationship with parental body mass index. Acta Paediatr 2004, 93:1-8.
• [3]Sjöberg A, Moraeus L, Yngve A, Poortvliet E, Al-Ansari U, Lissner L: Overweight and obesity in a representative sample of schoolchildren – exploring the urban–rural gradient in Sweden. Obes Rev 2011, 12(5):305-314.
• [4]Nader PR, O’Brien M, Houts R, Bradly R, Belsky J, Crosnoe R, Friedman S, Mei Z, Susman EJ: Identifying risk for obesity in early childhood. Pediatrics 2006, 118(3):594-601.
• [5]Salbe AD, Weyer C, Lindsay RS, Ravussin E, Tataranni PA: Asessing risk factors for obesity between childhood and adolescence: Birth weight, childhood adiposity, parental obesity, insulin and leptin. Pediatrics 2002, 110(2 Pt 1):299-306.
• [6]Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS: The relation of childhood BMI to adult adiposity: the Bogalusa heart study. Pediatrics 2005, 115(1):22-27.
• [7]Freedman DS, Dietz WH, Srinivasan SR, Berenson GS: The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa heart study. Pediatrics 1999, 103(6 Pt 1):1175-1182.
• [8]Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willet WC: Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994, 17(9):961-969.
• [9]Reilly JJ, Kelly J: Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond) 2011, 35(7):891-898.
• [10]Neovius M, Sundström J, Rasmussen F: Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study. BMJ 2009, 338:b496.
• [11]Griffiths LJ, Parsons TJ, Hill AJ: Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes 2010, 5(4):282-304.
• [12]Wardle J, Carnell S, Haworth CM, Plomin R: Evidence for a strong genetic influence on childhood adiposity despite the force of the obesogenic environment. Am J Clin Nutr 2008, 87(2):398-404.
• [13]Davison KK, Birch LL: Childhood overweight: a contextual model and recommendations for future research. Obes Rev 2001, 2(3):159-171.
• [14]Koch F-S, Sepa A, Ludvigsson J: Psychological stress and obesity. Journal of Paediatrics 2008, 153:6:839-844.
• [15]Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD: Interventions for preventing childhood obesity in children. Cochrane Database Syst Rev 2011, 7(12):CD001871.
• [16]Bond M, Wyatt K, Lloyd J, Welch K, Taylor R: Systematic review of the effectiveness and cost-effectiveness of weight management schemes for the under fives: a short report. Health Technol Assess 2009, 13(61):1-75. iii
• [17]Reinehr T, Kleber M, Lass N, Toschke AM: Body mass index patterns over 5 y in obese children motivated to participate in a 1-y lifestyle intervention: age as a predictor of long-term success. Am J Clin Nutr 2010, 91(5):1165-1171.
• [18]Salbin MA, Ford A, Hunt L, Jamal R, Crowne EC, Shield JP: Which factors are associated with a successful outcome in a weight management programme for obese children? J Eval Clin Pract 2007, 13(3):364-368.
• [19]Bluford DA, Sherry B, Scanlon KS: Interventions to prevent or treat obesity in preschool children: a review of evaluated programs. Obesity (Silver Spring) 2007, 15(6):1356-1372.
• [20]Hesketh K, Waters E, Green J, Salmon L, Williams J: Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health Promot Int 2005, 20(1):19-26.
• [21]Latzer Y, Edmunds L, Fenig S, Golan M, Gur E, Hochberg Z, Levin-Zamir D, Zubery E, Speiser PW, Stein D: Managing childhood overweight: behavior, family, pharmacology, and bariatric surgery interventions. Obesity (Silver Spring) 2009, 17(3):411-423.
• [22]Young KM, Northern JJ, Lister KM, Drummond JA, O’Brien WH: A meta-analysis of family-behavioral weight-loss treatments for children. Clin Psych Review 2007, 27(2):240-249.
• [23]Epstein LH, Valoski A, Wing RR, Mc Curley J: Ten year follow-up of behavioural, family based treatment for obese children. JAMA 1990, 21; 264(19):2519-2523.
• [24]Kitzmann KM, Beech BM: Family based interventions for pediatric obesity: methodological and conceptual challenges from family psychology. J Fam Psychol 2006, 20(2):175-189.
• [25]Golan M, Crow S: Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obesity Res 2004, 12(2):357-361.
• [26]West F, Sanders MR, Cleghorn GJ, Davies PS: Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change. Behav Res Ther 2010, 48(12):1170-1179.
• [27]Moher D, Schulz KF, Altman DG: The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol 2001, 1:2. BioMed Central Full Text
• [28]Karlberg J, Luo ZC, Albertsson-Wikland K: Body mass index reference values (mean and SD) for Swedish children. Acta Paediatr 2001, 90(12):1427-1434. Erratum: Acta Paediatr 2002, 91:362
• [29]Cole T, Belizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320:1240-1243.
• [30]Erlandsson LK: Stability in womens experiences of hassles and uplifts: A five year follow-up survey. Scand J Occup Ther 2008, 15(2):95-104.
• [31]Pearlin LI, Menaghan EG, Lieberman MA, Mullan JT: The stress process. J Health Soc Behav 1981, 22:337-356.
• [32]Ostberg M, Hagekull B, Wettergren S: A measure of parental stress in mothers with small children: Dimensionality, stability and validity. Scandinavian Journal of Psychology 1997, 40:199-208.
• [33]Östberg M, Hagekull B: Föräldrapåfrestning – the Swedish parenthood stress questionnaire. Unpublished manual. Akademiska Sjukhuset och Uppsala Universitet; 2000.
• [34]Abidin RR: Manual for the Parenting stress index. Odessa FL, US: Psychological Assessments Resources; 1995.