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Parents and Tots Together: Pilot randomized controlled trial of a family-based obesity prevention intervention in Canada

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Abstract

OBJECTIVE: To test the feasibility, acceptability and preliminary impact of Parents and Tots Together (PTT), a family-based obesity prevention intervention, in Canada.

PARTICIPANTS: Canadian parents of preschoolers (aged 2–5 years).

SETTING: Ontario Early Years centres in southwestern Ontario.

INTERVENTION: A pilot randomized controlled trial involving 48 parents who received either the PTT intervention (n = 27) or an attention-matched control home safety intervention (n = 21). To evaluate the feasibility of PTT, we assessed participant retention and outcome evaluation completion rates. To evaluate acceptability, we assessed program attendance and parents’ responses to program satisfaction surveys. To evaluate preliminary impact, we assessed children’s body mass index (BMI) at baseline, after intervention (end of 9-week intervention) and at 9-month follow-up. As well, at each time point, parents completed surveys assessing stress and self-efficacy related to parenting, children’s sleep, activity, TV viewing and diet.

OUTCOMES: Retention rates were high in the intervention (93%) and control (84%) study arms, and 87% of parents reported that they would highly recommend PTT to a friend. At 9-month follow-up, intervention parents reported lower parenting stress β̂ = 15.83, 95% confidence interval [CI] −29.57, −2.07, p = 0.02) and greater self-efficacy in managing their child’s behaviour (β̂ = 0.16, 95% CI 0.002, 0.33, p = 0.05) than control parents. PTT had minimal influence on children’s weight-related behaviours and BMI.

CONCLUSIONS: The results suggest that PTT can feasibly be implemented and tested in the Canadian context. Preliminary impact results suggest that the program may be effective in changing general parenting; however, program content should be modified to adequately address children’s weight-related behaviours.

Résumé

OBJECTIF : Tester la faisabilité, l’acceptabilité et l’impact préliminaire de Parents and Tots Together (PTT), une intervention de prévention de l’obésité menée auprès des familles au Canada.

PARTICIPANTS : Des parents canadiens d’enfants d’âge préscolaire (2–5 ans).

LIEU : Les Centres de la petite enfance du Sud-Ouest de l’Ontario.

INTERVENTION : Un essai pilote comparatif randomisé auprès de 48 parents ayant reçu soit l’intervention PTT (n = 27), soit une intervention-témoin sur la sécurité à domicile de même niveau d’attention (n = 21). Pour déterminer la faisabilité de PTT, nous avons évalué les taux de conservation des participants et leur taux de réponse aux questionnaires d’évaluation des résultats. Pour déterminer l’acceptabilité, nous avons évalué la fréquentation du programme et les réponses des parents aux sondages sur leur satisfaction par rapport au programme. Pour déterminer l’impact préliminaire, nous avons évalué l’indice de masse corporelle (IMC) des enfants au départ, après l’intervention (au bout de 9 semaines) et lors du suivi après 9 mois. De plus, à chaque étape, les parents ont rempli des questionnaires évaluant leur stress et leur autoefficacité liés à leur rôle parental et au sommeil, à l’activité, à l’écoute de la télévision et au régime des enfants.

EFFETS : Les taux de conservation ont été élevés pour l’intervention (93%) et pour l’étude témoin (84%), et 87% des parents ont déclaré qu’ils recommanderaient vivement le programme PTT à un ami. Au suivi après 9 mois, comparativement aux parents témoins, les parents de l’intervention ont fait état d’un stress moins élevé lié au rôle parental (β̂ = 15,83, intervalle de confiance [IC] de 95%: −29,57, −2,07, p = 0,02) et d’une autoefficacité plus élevée dans la gestion du comportement de leur enfant (β̂ = 0,16, IC de 95%: 0,002, 0,33, p = 0,05). Le programme PTT n’a eu qu’une influence minime sur les comportements liés au poids et sur l’IMC des enfants.

CONCLUSIONS : Les résultats montrent qu’il est faisable de mettre en œuvre et de tester le programme PTT dans le contexte canadien. Les résultats sur l’impact préliminaire montrent que le programme peut être efficace pour changer les compétences parentales en général, mais qu’il faudrait en modifier le contenu pour aborder convenablement les comportements liés au poids chez les enfants.

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References

  1. Shields M, Tremblay MS. Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. Int J Pediatr Obes 2010;5(3):265–73. PMID: 20210678. doi: 10.3109/17477160903268282.

    Article  Google Scholar 

  2. Shields M. Overweight Canadian Children and Adolescents: Nutrition: Findings from the Canadian Community Health Survey. Statistics Canada, 2008. Available at: http://www.statcan.gc.ca/pub/82-620-m/2005001/article/child-enfant/8061-eng.htm (Accessed December 1, 2015).

    Google Scholar 

  3. Shea C, Dwyer JJ, Heeney ES, Goy R, Simpson JR. The effect of parental feeding behaviours and participation of children in organized sports/ activities on child body mass index. Can J Diet Pract Res 2010;71(4):e87–93. PMID: 21144133.

    Article  Google Scholar 

  4. Baranowski T, Nader P. Family Health Behaviour. Health, Illness and Family: A Lifespan Perspective. New York: Wiley-Interscience, 1985:51–80.

    Google Scholar 

  5. Hanson NI, Neumark-Sztainer D, Eisenberg ME, Story M, Wall M. Associations between parental report of the home food environment and adolescent intakes of fruits, vegetables and dairy foods. Public Health Nutr 2005;8(1):77–85. PMID: 15705248. doi: 10.1079/PHN2004661.

    Article  Google Scholar 

  6. Zecevic CA, Tremblay L, Lovsin T, Michel L. Parental influence on young children’s physical activity. Int J Pediatr 2010;2010:468526. doi: 10.1155/ 2010/468526.

    Article  Google Scholar 

  7. Rhee KE, Lumeng JC, Appugliese DP, Kaciroti N, Bradley RH. Parenting styles and overweight status in first grade. Pediatrics 2006;117(6):2047–54. PMID: 16740847.

    Article  Google Scholar 

  8. Walton K, Simpson JR, Darlington G, Haines J. Parenting stress: A cross-sectional analysis of associations with childhood obesity, physical activity, and TV viewing. BMC Pediatr 2014;14:244. PMID: 25270356. doi: 10.1186/ 1471-2431-14-244.

    Article  Google Scholar 

  9. 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):1356–72. PMID: 17557972.

    Article  Google Scholar 

  10. Campbell KJ, Hesketh KD. Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obes Rev 2007; 8(4):327–38. PMID: 17578382. doi: 10.1111/j.1467-789X.2006.00305.x.

    Article  CAS  Google Scholar 

  11. Skouteris H, McCabe M, Swinburn B, Newgreen V, Sacher P, Chadwick P. Parental influence and obesity prevention in pre-schoolers: A systematic review of interventions. Obes Rev 2011;12(5):315–28. PMID: 20492538. doi: 10.1111/j.1467-789X.2010.00751.x.

    Article  CAS  Google Scholar 

  12. Haines J, Mayorga AM, McDonald J, O’Brien A, Gross D, Taveras EM, et al. Embedding weight-related messages within a general parenting programme: Development and feasibility evaluation of Parents and Tots Together. Early Child Dev Care 2012;182(8):951–65. doi: 10.1080/03004430.2012.678592.

    Article  Google Scholar 

  13. Gross D, Garvey C, Julion W, Fogg L, Tucker S, Mokros H. Efficacy of the Chicago parent program with low-income African American and Latino parents of young children. Prev Sci 2009;10(1):54–65. PMID: 19067166. doi: 10.1007/s11121-008-0116-7.

    Article  Google Scholar 

  14. Moens E, Braet C. Training parents of overweight children in parenting skills: A 12-month evaluation. Behav Cogn Psychother 2012;40(1):1–18. PMID: 21740603. doi: 10.1017/S1352465811000403.

    Article  Google Scholar 

  15. 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):1170–79. PMID: 20883981. doi: 10.1016/j.brat.2010.08.008.

    Article  Google Scholar 

  16. Harvey-Berino J, Rourke J. Obesity prevention in preschool native-American children: A pilot study using home visiting. Obes Res 2003;11(5):606–11. PMID: 12740449.

    Article  Google Scholar 

  17. Østbye T, Krause KM, Stroo M, Lovelady CA, Evenson KR, Peterson BL, et al. Parent-focused change to prevent obesity in preschoolers: Results from the KAN-DO study. Prev Med 2012;55(3):188–95. PMID: 22705016. doi: 10.1016/j. ypmed.2012.06.005.

    Article  Google Scholar 

  18. Ward DS, Vaughn AE, Bangdiwala KI, Campbell M, Jones DJ, Panter AT, et al. Integrating a family-focused approach into child obesity prevention: Rationale and design for the My Parenting SOS study randomized control trial. BMC Public Health 2011;11:431. doi: 10.1186/1471-2458-11-431.

    Article  Google Scholar 

  19. Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios LP, et al. A tutorial on pilot studies: The what, why and how. BMC Med Res Methodol 2010;10:1. PMID: 20053272. doi: 10.1186/1471-2288-10-1.

    Article  Google Scholar 

  20. Haines J, Neumark-Sztainer D, Perry CL, Hannan PJ, Levine MP. V.I.K. (Very Important Kids): A school-based program designed to reduce teasing and unhealthy weight-control behaviors. Health Educ Res 2006;21(6):884–95. doi: 10.1093/her/cyl123.

    Article  Google Scholar 

  21. Sorensen G, Emmons K, Hunt MK, Barbeau E, Goldman R, Peterson K, et al. Model for incorporating social context in health behavior interventions: Applications for cancer prevention for working-class, multiethnic populations. Prev Med 2003;37(3):188–97. PMID: 12914824. doi: 10.1016/ S0091-7435(03)00111-7.

    Article  Google Scholar 

  22. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall, Inc, 1986.

    Google Scholar 

  23. Armstrong L, J. Developing Effective Health Resources for Parents of Young Children: Findings from Qualitative Research. Guelph, ON: University of Guelph. Unpublished research.

  24. Coyne K, Kapuscinski L, Haines J. Parent Evaluation of Parent Education Videos to Improve Child Weight-Related Behaviours. Guelph, ON: University of Guelph. Unpublished research.

  25. McCabe KM, Clark R, Barnett D. Family protective factors among urban African American youth. J Clin Child Psychol 1999;28(2):137–50. PMID: 10353074. doi: 10.1207/s15374424jccp2802_2.

    Article  CAS  Google Scholar 

  26. Abidin R. Parenting Stress Index Short Form. Psychological Assessment Resources Inc., 1995.

    Google Scholar 

  27. Birch LL, Fisher JO, Grimm-Thomas K, Markey CN, Sawyer R, Johnson SL. Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 2001;36(3):201–10. PMID: 11358344.

    Article  CAS  Google Scholar 

  28. Taveras EM, Mitchell K, Gortmaker SL. Parental confidence in making overweight-related behavior changes. Pediatrics 2009;124(1):151–58. PMID: 19564295. doi: 10.1542/peds.2008-2892.

    Article  Google Scholar 

  29. Arredondo EM, Elder JP, Ayala GX, Campbell N, Baquero B, Duerksen S. Is parenting style related to children’s healthy eating and physical activity in Latino families? Health Educ Res 2006;21(6):862–71. doi: 10.1093/her/ cy1110.

    Article  Google Scholar 

  30. Blum RE, Wei EK, Rockett HR, Langeliers JD, Leppert J, Gardner JD, et al. Validation of a food frequency questionnaire in Native American and Caucasian children 1 to 5 years of age. Matern Child Health J 1999;3(3):167–72. PMID: 10746756. doi: 10.1023/A:1022350023163.

    Article  CAS  Google Scholar 

  31. Randall Simpson JA, Keller HH, Rysdale LA, Beyers JE. Nutrition Screening Tool for Every Preschooler (NutriSTEP): Validation and test-retest reliability of a parent-administered questionnaire assessing nutrition risk of preschoolers. Eur J Clin Nutr 2008;62(6):770–80. PMID: 17554250.

    Article  Google Scholar 

  32. Berge B. Qualitative Research Methods for the Social Sciences. Boston: Allyn & Bacon, 2009.

    Google Scholar 

  33. Canadian Task Force on Preventive Health Care. Recommendations for growth monitoring, and prevention and management of overweight and obesity in children and youth in primary care. CMAJ 2015;187(6):411–21. doi: 10.1503/cmaj.141285.

    Article  Google Scholar 

  34. Orrell-Valente JK, Pinderhughes EE, Valente E, Laird RD. If it’s offered, will they come? Influences on parents’ participation in a community-based conduct problems prevention program. Am J Community Psychol 1999;27(6):753–83.

    Article  CAS  Google Scholar 

  35. Williams NA, Coday M, Somes G, Tylavsky FA, Richey PA, Hare M. Risk factors for poor attendance in a family-based pediatric obesity intervention program for young children. J Dev Behav Pediatr 2010;31(9):705–12. PMID: 21057255. doi: 10.1097/DBP.0b013e3181f17b1c.

    Article  Google Scholar 

  36. Ingoldsby EM. Review of interventions to improve family engagement and retention in parent and child mental health programs. J Child Fam Stud 2010;19(5):629–45. doi: 10.1007/s10826-009-9350-2.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada

    Kathryn Walton MSc, RD, A. Jordan Filion MSc, RD, Janis Randall Simpson PhD, RD & Jess Haines PhD, RD

  2. Department of Nursing, Johns Hopkins University, Baltimore, MD, Canada

    Deborah Gross PhD, RN

  3. Department of Psychology, University of Guelph, Guelph, ON, Canada

    Barbara Morrongiello PhD & Sharon Hou BA

  4. Department of Mathematics and Statistics, University of Guelph, Guelph, ON, Canada

    Gerarda Darlington PhD

Authors
  1. Kathryn Walton MSc, RD
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  2. A. Jordan Filion MSc, RD
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  3. Deborah Gross PhD, RN
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  4. Barbara Morrongiello PhD
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Corresponding author

Correspondence to Kathryn Walton MSc, RD.

Additional information

Acknowledgements: We thank our colleagues from the Guelph Community Health Centre and Cambridge Ontario Early Years Centre for their insight and support regarding the implementation of this research.

Funding: Funding for this research was provided by the Danone Institute of Canada.

Conflict of Interest: Under an agreement between Rush University Medical Center and Dr. Deborah Gross, Dr. Gross is entitled to revenue from sales of the Chicago Parent Program. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. The authors have no further financial disclosures to declare.

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Walton, K., Filion, A.J., Gross, D. et al. Parents and Tots Together: Pilot randomized controlled trial of a family-based obesity prevention intervention in Canada. Can J Public Health 106, e555–e562 (2015). https://doi.org/10.17269/CJPH.106.5224

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  • DOI: https://doi.org/10.17269/CJPH.106.5224

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