Short-term efficacy of a childhood obesity prevention program designed to pair feeding content with nutrition education

Authors: HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); POWER, THOMAS - Washington State University; BAKER, SUSAN - Colorado State University; BARALE, KAREN - Washington State University Extension Service; ARAGON, M - Washington State University Extension Service; LANIGAN, JANE - Washington State University; PARKER, LOUISE - Washington State University Extension Service; SILVA GARCIA, KARINA - Washington State University; AULD, GARY - Colorado State University; JOHNSTON, CRAIG - University Of Houston; MICHELI, NILDA - Children'S Nutrition Research Center (CNRC)

Submitted to: Childhood Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/17/2022
Publication Date: 6/16/2022
Citation: Hughes, S.O., Power, T.G., Baker, S.S., Barale, K.V., Aragon, M.C., Lanigan, J.D., Parker, L., Silva Garcia, K., Auld, G., Johnston, C.A., Micheli, N. 2022. Short-term efficacy of a childhood obesity prevention program designed to pair feeding content with nutrition education. Childhood Obesity. https://doi.org/10.1089/chi.2022.0030.
DOI: https://doi.org/10.1089/chi.2022.0030

Interpretive Summary: Family based obesity prevention programs targeting early childhood show the greatest promise because parents typically have primary control over their child's eating. We developed the Food, Feeding and Your Family (FFYF) program by adding content from a previously validated feeding program (i.e., Strategies for Effective Eating Development) to a widely used nutrition education curriculum for families in low-resourced communities. The goal of FFYF was to encourage eating self-regulation in children. This article describes results from a randomized controlled trial (RCT) that examined the efficacy of delivering FFYF in three ways: in-class nutrition education only, in-class nutrition education with in-class feeding content, or in-class nutrition education with online feeding content. The RCT was conducted through the Expanded Food and Nutrition Education Program in the states of Colorado and Washington. A total of 382 parents completed assessments of feeding practices, child eating behaviors, feeding styles, and acculturation before and immediately after the delivery of FFYF. Results showed considerable support for the influence of FFYF on parents' feeding knowledge, practices, and styles. The online and in-class approaches were equally effective as delivery methods. The most consistent effects across the two methods were for encouraging children to try new foods, use of child-centered (versus parent-centered) feeding strategies, child involvement in food preparation, and understanding the number of exposures required for child acceptance of a new food. In sum, results of this study showed that FFYF positively influenced feeding behaviors in both English and Spanish speaking families with low incomes. Given limited information on the efficacy of using mobile health in prevention programs, the finding that online and in-class methods were equally effective increases opportunities to reach and engage more families from low-resource communities.

Technical Abstract: Family-based programs show considerable promise in preventing overweight and obesity in young children. However, dissemination is difficult because significant participant and staff involvement is required. This study examined the short-term efficacy of adding parental feeding content to a widely-used nutrition education curriculum for families in low-resourced communities comparing the influence of two delivery methods (in-class and online) on parents' feeding knowledge, practices, and styles. In this cluster randomized controlled trial, parents of 2–8-year-old children enrolled in the EFNEP in Colorado and Washington were randomly assigned to: in-class nutrition education only, in-class nutrition education with in-class feeding content, or in-class nutrition education with online feeding content. Data from the 382 participants who completed both pretest and posttest assessments are reported here. Multi-level analyses showed empirical support for the influence of the program on parents' feeding knowledge, practices, and styles. Online and in-class methods were equally effective in delivering feeding content in low-resourced communities. Consistent effects were seen across the two delivery methods for encouraging children to try new foods (p < .05), use of child-centered feeding practices (i.e., greater responsiveness, p < .05), child involvement in food preparation (p < .05), and understanding the number of presentations often necessary for child acceptance of a new food (p < .001). Location and language differences were seen across some constructs. This study demonstrates the efficacy of in-class and online approaches to feeding highlighting the program's positive effects on promoting healthy feeding behaviors for parents of children in low-resourced families.