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Preventing Weight Gain and Obesity: Indirect Effects of the Family Check-Up in Early Childhood

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An Erratum to this article was published on 06 March 2015

Abstract

The early signs of obesity are observable in early childhood. Although the most promising prevention approaches are family-centered, few relevant early prevention programs exist. This study evaluated the effects of an evidence-based, home-visiting intervention, the Family Check-Up (FCU), on the trajectory of children’s weight gain. The FCU was designed to prevent the development of behavior problems by improving family management practices; children’s weight has not been an explicit target. On the basis of previous research and conceptual models, we hypothesized that intervention effects on parenting practices, specifically caregivers’ use of positive behavior support (PBS) strategies in toddlerhood, would mediate improvements in children’s weight trajectories. A total of 731 indigent caregiver–child dyads from a multisite randomized intervention trial were examined. Observational assessment of parenting and mealtime behaviors occurred from age 2–5 years. The child’s body mass index (BMI) was assessed yearly from age 5–9.5 years. Path analysis with a latent growth model revealed a significant indirect effect of the FCU on the trajectory of BMI in later childhood. Improvements in caregivers’ PBS in toddlerhood, which was related to the nutritional quality of the meals caregivers served to the child during the mealtime task, served as the intervening process. Furthermore, findings indicate that the FCU prevents progression to overweight and obese status amongst at-risk children. These study results add to existing evidence that has demonstrated that family-based interventions aimed at improving general family management skills are effective at preventing weight gain. Future directions are discussed.

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Acknowledgments

This research was supported by National Institute on Drug Abuse grant DA016110 to the third, fourth, and fifth authors. The second author was supported by minority fellowship SM60563-40 from the Department of Health and Human Services. Seed funding from the College of Liberal Arts and Sciences at Arizona State University awarded to Thomas Dishion supported the first and second authors. The authors also gratefully thank Charlotte Winter and Shannon McGill for assistance with the data management, Cheryl Mikkola for editorial support, the observational coding team at the Child and Family Center, the rest of the Early Steps team in Eugene, Pittsburgh, and Charlottesville, and the families who have participated in the study.

Conflict of Interest

Justin D. Smith, Zorash Montaño, Thomas J. Dishion, Daniel S. Shaw, and Melvin N. Wilson have no conflicts of interest or financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. REACH Institute, Arizona State University, Phoenix, AZ, USA

    Justin D. Smith, Zorash Montaño & Thomas J. Dishion

  2. Child and Family Center, University of Oregon, Eugene, OR, USA

    Thomas J. Dishion

  3. University of Pittsburgh, Pittsburgh, PA, USA

    Daniel S. Shaw

  4. University of Virginia, Charlottesville, VA, USA

    Melvin N. Wilson

  5. Department of Psychology and Neuroscience, Baylor University, One Bear Place, Waco, TX, USA

    Justin D. Smith

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  1. Justin D. Smith
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Correspondence to Justin D. Smith.

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Smith, J.D., Montaño, Z., Dishion, T.J. et al. Preventing Weight Gain and Obesity: Indirect Effects of the Family Check-Up in Early Childhood. Prev Sci 16, 408–419 (2015). https://doi.org/10.1007/s11121-014-0505-z

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