Evaluation of a cluster-randomized controlled trial: Communities for Healthy Living, family-centered obesity prevention program for Head Start parents and children

International Journal of Behavioral Nutrition and Physical Activity

Research

Kindra Lansburg¹  Merieka Torrico¹  Jessie Leonard²  Sebastien Haneuse³  Evelin A. Garcia⁴  Janine K. Jurkowski⁵  Erica L. Kenney⁶  Cristina Gago⁶  Josiemer Mattei⁶  Nicole Kitos⁶  Roger Figueroa⁷  Xinting Yu⁸  Alyssa Aftosmes-Tobio⁸  Carly Oddleifson⁸  Kirsten K. Davison⁸  Jacob P. Beckerman-Hsu⁸ 

[1] Action for Boston Community Development (ABCD), 02111, Boston, MA, USA;Community Action Agency of Somerville (CAAS), 02143, Somerville, MA, USA;Department of Biostatistics, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA;Department of Global Health & Population, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA;Department of Health Policy, Management, and Behavior, State University of New York, 12222, Albany, NY, USA;Department of Nutrition, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA;Division of Nutritional Sciences, College of Human Ecology, Cornell University, 14853, Ithaca, NY, USA;School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, 02467, Chestnut Hill, MA, USA;

关键词: Empowerment;    Early childhood;    Childhood obesity;    Obesity prevention trial;    Community-based participatory research;    Family-centered intervention;    Child weight-related behaviors;    Parenting practices;   

DOI  :  10.1186/s12966-022-01400-2

 received in 2022-06-07, accepted in 2022-12-08,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThis study reports the outcomes of Communities for Healthy Living (CHL), a cluster randomized obesity prevention trial implemented in partnership with Head Start, a federally-funded preschool program for low-income families.MethodsUsing a stepped wedge design, Head Start programs (n = 16; Boston, MA, USA) were randomly assigned to one of three intervention start times. CHL involved a media campaign and enhanced nutrition support. Parents were invited to join Parents Connect for Healthy Living (PConnect), a 10-week wellness program. At the beginning and end of each school year (2017-2019), data were collected on the primary outcome of child Body Mass Index z-score (BMIz) and modified BMIz, and secondary outcomes of child weight-related behaviors (diet, physical activity, sleep, media use) and parents’ weight-related parenting practices and empowerment. Data from 2 years, rather than three, were utilized to evaluate CHL due to the COVID-19 pandemic. We used mixed effects linear regression to compare relative differences during intervention vs. control periods (n = 1274 vs. 2476 children) in (1) mean change in child BMIz and modified BMIz, (2) the odds of meeting child health behavior recommendations, (3) mean change in parenting practices, and (4) mean change in parent empowerment. We also compared outcomes among parents who chose post-randomization to participate in PConnect vs. not (n = 55 vs. 443).ResultsDuring intervention periods (vs. control), children experienced greater increases in BMIz and modified BMIz (b = 0.06, 95% CI = 0.02,0.10; b = 0.07, 95% CI = 0.03, 0.12), yet were more likely to meet recommendations related to three of eight measured behaviors: sugar-sweetened beverage consumption (i.e., rarely consume; Odds Ratio (OR) = 1.5, 95% CI = 1.2,2.3), water consumption (i.e., multiple times per day; OR = 1.6, 95% CI = 1.2,2.3), and screen time (i.e., ≤1 hour/day; OR = 1.4, 95% CI = 1.0,1.8). No statistically significant differences for intervention (vs. control) periods were observed in parent empowerment or parenting practices. However, parents who enrolled in PConnect (vs. not) demonstrated greater increases in empowerment (b = 0.17, 95% CI = 0.04,0.31).ConclusionsInterventions that emphasize parent engagement may increase parental empowerment. Intervention exposure was associated with statistically, but not clinically, significant increases in BMIz and increased odds of meeting recommendations for three child behaviors; premature trial suspension may explain mixed results.Trial registrationClinicalTrials.gov, NCT03334669, Registered October 2017.

【 授权许可】

CC BY   
© The Author(s) 2023

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