A Home-Based Parent-Child Intervention to Promote Children's Energy Balance

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DESCRIPTION (provided by applicant): This investigation will develop and pilot test a home-based intervention to modify parenting practices that influence children's eating patterns, physical activity, and media use behaviors and thereby influence children's risk of unhealthy weight gain. Aim 1: Develop a home-based intervention to modify parenting practices that influence children's risk of unhealthy weight gain. During program development the investigators will apply a successful model of a home-based parenting program for smoking prevention developed by the Principal Investigator in prior research, they will involve parents and children in screening the intervention concepts and field testing intervention prototypes, and they will utilize expert consultation on nutrition and physical activity intervention and assessment. The complete intervention will be a six month series of intervention activity guides that rely on interactive games and other forms of experiential learning to engage parents and children jointly in modifying diet, physical activity, and media use practices that promote unhealthy weight gain. Aim 2: Conduct a small sample pilot study to measure the effects of the intervention on parenting practices and on children's dietary, physical activity, and media use behaviors. At baseline, 240 dyads of mothers and seven year old children will be recruited. Mothers will be biological mothers, step- mothers, foster mothers, or other female guardians of any racial/ethnicity group; children will be boys or girls who are at-risk or nearly-at-risk of becoming overweight (defined as sex-specific BMI-for-age = 80th and < 95th percentile). Following baseline assessments completed by mothers and children on site (at Principal InvestigatorRE), participants will be randomly assigned to a 6-month treatment or to a delayed treatment control condition (controls will receive intervention materials after follow-up). Intervention exposure and fidelity will be measured using telephone interviews conducted monthly with random subsets of treatment group parents. Follow-up data collection will repeat the baseline assessment protocol for mothers and children. Regression models will be used to test the hypothesis that parents exposed to the intervention will be significantly more likely than controls to use parenting practices that promote healthy weight gain. Regression models will also test whether children in the treatment group are significantly more likely than controls to report recommended dietary, physical activity, and media use behaviors. Pediatric obesity has become increasingly prevalent and is associated with increased risk of multiple chronic diseases. Children whose diet, physical activity, and media use behaviors promote energy balance could experience long-term health benefits. For children to benefit, parents must have the knowledge, basic skills, and socialization tools they need to modify relevant socialization processes. The proposed research aims to develop a program that will meet this need.