Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study

The purpose of this study was to evaluate a theory-based, multicomponent eHealth intervention aimed at improving child health behaviors and parental psychosocial attributes and feeding practices. A pilot randomized controlled trial was conducted among 73 parents with children (1–3 years). Intervention group participants (IG, n = 37) received theory-based educational videos, cooking tutorials, and text messages with key information for a total of 8 weeks. Control group participants (CG, n = 36) received a booklet about general nutrition recommendations for children. A parent-administered questionnaire was used for data collection at baseline and post-intervention. Linear models were performed using R version 4.1.1. for data analysis. Children in the IG significantly increased their daily intake of fruit (ΔΔ = 0.89 servings, p = 0.00057) and vegetables (ΔΔ = 0.60 servings, p = 0.0037) and decreased use of screen time (ΔΔ = −33.87 min, p = 0.026), compared to the CG. Parents in the IG improved significantly more than the CG in self-efficacy (p = 0.0068) and comprehensive feeding practices (p = 0.0069). There were no significant differences between the study groups for changes in child outcomes, such as physical activity and sedentary behaviors, and parental nutrition knowledge and attitudes.

[1]  J. Ng,et al.  Improving children’s fundamental movement skills through a family-based physical activity program: results from the “Active 1 + FUN” randomized controlled trial , 2021, International Journal of Behavioral Nutrition and Physical Activity.

[2]  J. Steinacker,et al.  Parental Self-Efficacy as a Predictor of Children’s Nutrition and the Potential Mediator Effect between the Health Promotion Program “Join the Healthy Boat” and Children’s Nutrition , 2020, International journal of environmental research and public health.

[3]  M. Allman-Farinelli,et al.  Effectiveness of Family-Based Behavior Change Interventions on Obesity-Related Behavior Change in Children: A Realist Synthesis , 2020, International journal of environmental research and public health.

[4]  H. Salihu,et al.  Social Determinants of Overweight and Obesity Among Children in the United States , 2019, International journal of MCH and AIDS.

[5]  Barent N. McCool,et al.  mHealth Improved Fruit and Vegetable Accessibility and Intake in Young Children , 2019, Journal of nutrition education and behavior.

[6]  Michael W. Beets,et al.  Disparities in childhood overweight and obesity by income in the United States: an epidemiological examination using three nationally representative datasets , 2019, International Journal of Obesity.

[7]  R. Jones,et al.  An Internet-Based Childhood Obesity Prevention Program (Time2bHealthy) for Parents of Preschool-Aged Children: Randomized Controlled Trial , 2019, Journal of medical Internet research.

[8]  Helena H. Laroche,et al.  Diet and physical activity changes among low-income families: perspectives of mothers and their children , 2019, International journal of qualitative studies on health and well-being.

[9]  Goutham Rao,et al.  Sedentary Behaviors in Today’s Youth: Approaches to the Prevention and Management of Childhood Obesity A Scientific Statement From the American Heart Association , 2018, Circulation.

[10]  G. Ambrosini,et al.  Unhealthy Dietary Patterns Established in Infancy Track to Mid-Childhood: The EU Childhood Obesity Project. , 2018, The Journal of nutrition.

[11]  Mi Zhang,et al.  Using Facebook in a Healthy Lifestyle Intervention: Feasibility and Preliminary Efficacy , 2018, Western journal of nursing research.

[12]  C. D. Jensen,et al.  Effectiveness of a Parent Health Report in Increasing Fruit and Vegetable Consumption Among Preschoolers and Kindergarteners , 2017, Journal of nutrition education and behavior.

[13]  G. Cardon,et al.  The effect of an online video intervention ‘Movie Models’ on specific parenting practices and parental self-efficacy related to children’s physical activity, screen-time and healthy diet: a quasi experimental study , 2017, BMC Public Health.

[14]  J. Salmon,et al.  Interventions to reduce sedentary behaviour in 0–5-year-olds: a systematic review and meta-analysis of randomised controlled trials , 2016, British Journal of Sports Medicine.

[15]  Ruth P Saunders,et al.  An Intervention to Increase Physical Activity in Children: A Randomized Controlled Trial With 4-Year-Olds in Preschools. , 2016, American journal of preventive medicine.

[16]  S. Clemes,et al.  Reliability and Validity of the Early Years Physical Activity Questionnaire (EY-PAQ) , 2016, Sports.

[17]  B. Swinburn,et al.  A parent‐based intervention to promote healthy eating and active behaviours in pre‐school children: evaluation of the MEND 2–4 randomized controlled trial , 2016, Pediatric obesity.

[18]  M. Sharma,et al.  One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial , 2016, Health education & behavior : the official publication of the Society for Public Health Education.

[19]  N. Martin,et al.  Parenting Styles, Feeding Styles, Feeding Practices, and Weight Status in 4–12 Year-Old Children: A Systematic Review of the Literature , 2015, Front. Psychol..

[20]  Maria de Fátima Goulão,et al.  Learner Autonomy and Self-regulation in eLearning , 2015 .

[21]  Katrina Butner,et al.  Physical activity guidelines for americans midcourse report: Strategies to increase physical activity among youth , 2013 .

[22]  M. Nydahl,et al.  Agreement between different methods of measuring height in elderly patients. , 2013, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[23]  A. Magarey,et al.  Reliability of Questionnaires to Assess the Healthy Eating and Activity Environment of a Child's Home and School , 2013, Journal of obesity.

[24]  M. Onis,et al.  Defining obesity risk status in the general childhood population: which cut-offs should we use? , 2010, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[25]  L. Grummer-Strawn,et al.  Use of World Health Organization and CDC Growth Charts for Children Aged 0–59 Months in the United States (Excerpt) , 2010, Clinical Lactation.

[26]  J. Blissett,et al.  Inducing preschool children's emotional eating: relations with parental feeding practices. , 2010, The American journal of clinical nutrition.

[27]  F. Huffman,et al.  Parenthood—A Contributing Factor to Childhood Obesity , 2010, International journal of environmental research and public health.

[28]  K. Kypri,et al.  Obtaining active parental consent for school‐based research: a guide for researchers , 2009, Australian and New Zealand journal of public health.

[29]  N. DiMarco,et al.  Mothers of preschoolers report using less pressure in child feeding situations following a newsletter intervention. , 2008, Journal of nutrition education and behavior.

[30]  Shayla C. Holub,et al.  Comprehensive Feeding Practices Questionnaire: validation of a new measure of parental feeding practices. , 2007, Journal of pediatric psychology.

[31]  K. Kelleher,et al.  Perceived Barriers to Treatment and Psychotherapy Attendance in Child Community Mental Health Centers , 2006, Community Mental Health Journal.

[32]  M. Stommel,et al.  Nutrition education aimed at toddlers: an intervention study , 2005, Pediatric Nursing.

[33]  J. Harvey-Berino,et al.  Obesity prevention in preschool native-american children: a pilot study using home visiting. , 2003, Obesity research.

[34]  E. A. Locke,et al.  Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. , 2002, The American psychologist.

[35]  L. Birch,et al.  Childhood overweight: a contextual model and recommendations for future research , 2001, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[36]  R. Spoth,et al.  Research on Family Engagement in Preventive Interventions: Toward Improved Use of Scientific Findings in Primary Prevention Practice , 2000, Journal of Primary Prevention.

[37]  A. Kazdin,et al.  Family experience of barriers to treatment and premature termination from child therapy. , 1997, Journal of consulting and clinical psychology.

[38]  U. Bronfenbrenner Ecology of the family as a context for human development: research perspectives , 1986 .

[39]  N. Nathan,et al.  Interventions for increasing fruit and vegetable consumption in children aged five years and under. , 2018, The Cochrane database of systematic reviews.

[40]  Larry J. Anderson,et al.  Morbidity and Mortality Weekly Report , 2002 .