Developing a Preschool Obesity Intervention for Families Enrolled in WIC

Very few studies have targeted weight control in preschoolers even though the prevalence of
overweight has exceeded 20% in this age-group for the past decade. Also concerning is that
few studies have focused on preschoolers from low-socioeconomic (SES) backgrounds despite
persistent obesity-related socioeconomic disparities. Family-based, behavioral interventions
appear a promising model for treatment of obesity in early childhood. However, the
dissemination potential of these programs is unclear as they have primarily been tested with
families from middle-to-upper class backgrounds and within research settings. Identifying
effective approaches to weight control for preschoolers from low-SES backgrounds that can be
delivered in community settings is imperative to reducing the pediatric obesity epidemic.
The proposed study will begin to address this critical gap by completing the second phase of
developing a community-based preschool weight control intervention for families enrolled in
the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The
proposed study is significant because we specifically target preschool weight control in a
high-risk population and because delivery of our program within the WIC program is conducive
to its dissemination. Based upon our formative work, and existing preschool obesity
programs, we have developed a 14-session, family-based preschool weight control intervention
(FBWC) that emphasizes experiential learning and is delivered in the WIC and home settings.
Seventy-two overweight and obese preschool-caregiver dyads will be randomized in a 2:1 ratio
to receive FBWC or to continue with standard of care at WIC (WSOC). The primary study aims
are to a) examine the feasibility and acceptability of FBWC and b) explore the preliminary
efficacy of FBWC compared to WSOC on reduction in preschooler BMI-z-score and caregiver BMI
from baseline to post-treatment (4-months) and 7-months (3-month follow-up). An exploratory
aim is to evaluate lifestyle and behavioral indicators of intervention success. This study
is innovative because: 1) very few studies have examined obesity intervention in
preschoolers, 2) we target weight control in a high-risk group that has been
underrepresented in the preschool obesity treatment outcome literature, 3) our intervention
is community-based, and 4) we emphasize experiential learning as a strategy for achieving
lifestyle behavior change and weight control.

Inclusion Criteria:

- family receiving services at Detroit-based WIC clinics

- preschooler between the ages of 2 years and 4 years, 7 months and BMI>85th percentile

- one primary caregiver who is willing to participate and whose BMI>25

- family is English-speaking

- preschooler has medical clearance to participate in the intervention

- caregiver has medical clearance to participate in the intervention if indicated by
physical activity screening questions

Exclusion Criteria:

- preschooler or caregiver is participating in a different weight management program

- preschooler or caregiver has a condition that precludes participation in moderate
level activity

- preschooler or caregiver is diagnosed with a weight-affecting health condition

- preschooler or caregiver is taking weight-affecting medications

- preschooler or caregiver is diagnosed with a developmental delay or disability

- caregiver is receiving treatment for severe psychopathology

- family plans to be out of town for more than 2 weeks of the first 4 months of their
research participation

- family plans to move from Detroit in the next 7 months