Twelve-month efficacy of an obesity prevention program targeting Hispanic families with preschoolers from low-income backgrounds

Authors: HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); POWER, THOMAS - Washington State University; BECK, ASHLEY - Spokane Regional Health District; BETZ, DREW - Washington State University; GOODELL, LORI - North Carolina State University; HOPWOOD, VERONICA - Pullman Regional Hospital; JARAMILLO, J - Children'S Nutrition Research Center (CNRC); LANIGAN, JANE - Washington State University; MARTINEZ, ANAMARIA - Washington State University; MICHELI, NILDA - Children'S Nutrition Research Center (CNRC); GUERRERO, YADIRA - Michigan State University; OVERATH, IRENE - Washington State University; PARKER, LOUISE - Washington State University Extension Service; RAMOS, GUADALUPE - University Of Southern California; THOMPSON, YURI - University Of Houston; PAPAIOANNOU, MARIA - Children'S Nutrition Research Center (CNRC); JOHNSON, SUSAN - University Of Colorado

Submitted to: Journal of Nutrition Education and Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/13/2021
Publication Date: 6/17/2021
Citation: Hughes, S.O., Power, T.G., Beck, A.D., Betz, D., Goodell, L.S., Hopwood, V., Jaramillo, J.A., Lanigan, J., Martinez, A.D., Micheli, N., Guerrero, Y.O., Overath, I., Parker, L., Ramos, G., Thompson, Y.P., Papaioannou, M.A., Johnson, S.L. 2021. Twelve-month efficacy of an obesity prevention program targeting Hispanic families with preschoolers from low-income backgrounds. Journal of Nutrition Education and Behavior. https://doi.org/10.1016/j.jneb.2021.04.460.
DOI: https://doi.org/10.1016/j.jneb.2021.04.460

Interpretive Summary: A wide range of prevention programs have been developed to prevent overweight and obesity in children and youth. Most programs have met with minimal success, especially when examining long-term outcomes on child weight status. Moreover, only a few successful obesity prevention programs for children and youth have been specifically designed for ethnically diverse populations with low incomes. To address these gaps, the Strategies for Effective Eating Development (SEEDS) prevention program was developed for parents of preschool children from low-income backgrounds. The overall goal of the program was to teach parents and children to pay attention to children's internal cues of hunger and fullness. The secondary goal was to teach parents to help their children learn to explore and try novel foods such as fruits and vegetables. In this study, we examined the twelve-month effects of the program in promoting eating self-regulation and healthy food preferences in low-income Hispanic children. A total of 255 mothers and their preschool child were randomized into two groups and participated in the 7-week program which included parent-, child-, and family-based lessons. The prevention group contained 136 parent/child dyads and the control group contained 119 parent/child dyads. Parents and children were assessed before the program begun, immediately after it ended, and again 12 months after it ended. This study reports results on the longer-term assessments. The most important effect of the SEEDS program was the reduced likelihood of Hispanic children having overweight or obesity at the 12-month follow-up for those who participated with their mothers in the prevention group. The SEEDS prevention program also showed positive changes in parental feeding behaviors at the 12-month follow-up. Finally, dosage (maternal attendance in 0 to 7 lessons) predicted maternal outcomes (i.e., encouraging exploration of new foods, serving measured portions, knowledge of best practices, knowledge regarding repeated presentation of new foods, and home feeding efficacy) as well. The current study demonstrates the value of a family-focused approach to changing maternal feeding practices and that a family-based approach can lead to positive outcomes in addressing the problem of childhood obesity.

Technical Abstract: Assess effects of an obesity prevention program promoting eating self-regulation and healthy preferences in Hispanic preschool children. Randomized controlled trial with pretest, posttest, 6- and 12-month assessments. Fourteen waves each lasting 7 weeks. Families recruited from Head Start across 2 sites. 255 families randomized into prevention (n = 136) or control (n = 119). Prevention received curriculum; control received no curriculum. Feeding knowledge/practices/styles (parent); BMI percentile, eating self-regulation, trying new foods, and fruit/vegetable consumption (child). Multilevel analyses for nested data (time points within families; families within waves) and multinomial regression. Program increased mothers’ repeated presentation of new foods (p < .05), measured portion sizes (p < .05), child involvement in food preparation (p < .001), feeding responsiveness (p < .001), knowledge of best feeding practices (p < .001) and feeding efficacy (p < .05); reduced feeding misconceptions (p < .01) and uninvolved feeding (p < .01). Effects on child eating behavior were minimal. At 12 months, children in the prevention group were less likely to have overweight (p < .05) or obesity (p < .05). Program effects emphasize importance of feeding approaches in reducing childhood obesity.