Developing tailored home environment interventions to address childhood obesity

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DESCRIPTION (provided by investigator): Obesity is a serious health problem in the US that increases risk of certain cancers, heart disease and diabetes. Childhood obesity is particularly prevalent in low income, Black and Latino children. The prevention and treatment of overweight in youth hinges on helping families develop new lifestyles and create supportive environments in which healthful eating and physical activity (PA) can be promoted. There is a pressing need to develop and test childhood obesity prevention and treatment approaches for low income and minority families that are effective, but also culturally acceptable and sustainable. The purposes of the current proposed R21 project are to: 1). conduct formative research to inform the development of culturally appropriate evaluation tools and family-tailored interventions for low income ethnically diverse parents of children aged 2-5; and 2). conduct a pilot feasibility study to inform the design and implementation of a future RCT. In Year 01, we will conduct formative research including: a). Focus groups with WIC nutritionists to explore their insights into educating low income parents of young children about diet, PA and childhood obesity prevention; b). Focus groups with target audience parents to determine target behaviors, performance objectives, personal and external determinants, change objectives and intervention methods/strategies re. healthy eating, PA and weight control; c). Cognitive assessment testing with target audience parents on existing instruments for measuring children's dietary and PA behaviors, the social and physical home environment and relevant psychosocial issues to revise these tools so they are culturally and linguistically appropriate. This information will be used to develop intervention and evaluation tools. In Year 02, we will conduct a pilot feasibility study to inform the future RCT. The pilot study will: a). determine the feasibility of subject recruitment and retention methods, interventions, process and outcome evaluation methods and measures; b) implement process evaluation to determine implementation fidelity including dose and its' relationship with primary and secondary outcome measures; c). Explore relationships between primary and secondary outcome measures and potential mediating variables In the pilot study, 50 parent-child pairs will receive the tailored intervention, which will be delivered to parents will include: a family exercise video, a TV monitor, 4 sets of culturally and linguistically appropriate individually tailored low literacy written materials interspersed with telephone counseling calls that will be delivered three times over a 20 week period to the parent/family. The intervention will focus on helping parents to develop new lifestyles and create supportive environments to promote/facilitate healthful eating and PA in their children. At the end of Year 02, we will compile all qualitative and quantitative formative, process and outcome evaluation data and apply it using an intervention mapping approach to plan a future RCT that will test the efficacy of tailored home-based interventions on BMI measures, dietary and PA behaviors of children, and the social and physical home environment. PUBLIC HEALTH RELEVANCE: Childhood obesity is a serious health problem in the US as the prevalence is high and increasing, especially in low income as well as African American and Hispanic children. The proposed project will conduct formative research and a feasibility study to inform a future randomized controlled trial that will test the effectiveness of sustainable interventions to prevent/treat childhood obesity in low income, ethnically diverse families.