Healthy Homes, Healthy Habits

Participants will be 298 mothers (>50% African American; 100% meet federal poverty level) and
their children (3-5yo at baseline) enrolled in our home visitation partner in central
Alabama. Home visitors will be randomly assigned to deliver the home visitation curriculum
with or without HABITS (an obesity prevention program targeting key eating and activity
behaviors) as part of their weekly home visits for 9 months. Treatment sessions for standard
of care or standard + HABITS arms will be facilitated by trained home visitors. If a mother
or primary caregiver and her child are randomized to participate in the HABITS + Standard
home visitation curriculum, they will receive ~15 minutes of information, activities, and
assistance regarding the development of key behaviors relating to obesity prevention, which
will be imbedded within the existing home visitation curriculum. The HABITS program will
address habit-formation of four behaviors relevant to mothers or primary caregivers and
children: (1) limit fried foods; (2) limit sugar-sweetened beverages (SSB); (3) increase
daily steps; (4) increase fruits and vegetables. Additionally, mothers or primary caregivers
will also practice habit formation focused on self-monitoring of weight and the four
behaviors previously mentioned. Skill training will focus on habit formation and home
environment modification conducive to the four behaviors.

Mothers or primary caregivers in the intervention group will be provided the HABITS +
standard home visitation program for 9 months, while those in the control group will be
provided the standard home visitation program during this time. Treatment in the control arm
includes the content and services typically provided by the home visitation partner, which is
focused on strengthening children's cognitive skills, early literacy skills, social/emotional
and physical development.

Inclusion Criteria:

*Important: Mother (or caregiver) and child dyads are enrolled together. Both must meet
inclusion criteria to participate.

Mothers or Primary Caregivers:

- Age 14-75 years of age, with parental consent given for mothers between 14-18 years of
age.

- Enrollment in Home Instruction for Parents of Preschool Youngsters (HIPPY) program
through Healthy Kids Alabama- Montgomery Branch.

- Mother or primary caregiver of 3-5 year old child

- BMI above 18.5

- Generally Healthy

Children:

- 3-4 years of age at time of enrollment

- Parent or primary caregiver enrolled in HIPPY- Alabama

Exclusion Criteria:

Mothers or primary caregivers:

- Any history of an eating or feeding disorder, or obesity related syndrome (such as
Prader-Willi)

- Diagnosis of Schizophrenia

- Currently enrolled in a diet and weight loss program, AND either a) significant weight
loss of 10+ pounds in the last 6 months, OR b) unwilling to discontinue from current
diet and weight loss program.

Children:

- Child is clinically underweight (<5th percentile) or has a history of a feeding or
eating disorder