Study of Parenting Intervention to Prevent Child Obesity

The early years between ages 3-7 are critical in the development of obesity. The importance
of the family in the development of children's eating and activity behaviors has been
emphasized by experts, yet to date no obesity prevention interventions incorporating a
strong family focus with emphasis on improved parenting practices have been developed. The
work proposed here will address this gap by testing the efficacy of an 8-mo parenting
intervention designed to change both social and physical aspects of the home environment,
which in turn will reduced % body fat in children. Subjects will be 280 families (one parent
and one child from each) with at least one preschool-age child (2-5 years old). Following
baseline measures, pairs will be randomized into intervention or control. The intervention
will teach more effective parenting skills (child management, communication, routines,
etc.), then apply these skills to specific practices that encourage healthier behaviors. The
intervention will include group sessions and tailored phone calls facilitated by a
registered dietitian who has also received training in parent education. Group sessions will
use multiple teaching strategies and include separate child activities. Tailored calls will
use motivational interviewing techniques to help parents overcome barriers to behavior
change. The intervention is guided by Darling and Steinberg's Integrative Model of
parenting, which highlights the importance of parenting values, style and practices in child
socialization, and Deci and Ryan's Self-Determination Theory, which suggests ways to foster
autonomous motivation to adopt new behaviors. The resulting intervention will help parents
learn skills to reduce their parenting-related stress and create home environments that
support healthy-weight behaviors. The primary outcome, % body fat in children, will be
assessed using anthropometry and a validated prediction equation (Dezenberg, 1999).
Analyses will include baseline measurements of the outcome as a covariate. Secondary
measures include child and parent diet and physical activity, parenting style and practices,
and home environment. Maintenance effect will be assessed following a 6-mo no-intervention
period. A comprehensive analysis is included to test for mediation effects. This intensive
intervention will create the exposure necessary to make life-altering changes in
weight-related behaviors. Plans build on extensive formative work conducted by our
experienced researchers.