ARS | Publication request: Outcomes of a pilot obesity prevention plus intervention targeting children and parenting practices

Submitted to: Pediatric Academic Society
Publication Type: Abstract Only
Publication Acceptance Date: January 1, 2010
Publication Date: May 1, 2010
Citation: O'Connor, T.M., Hilmers, A., Watson, K., Baranowski, T. 2010. Outcomes of a pilot obesity prevention plus intervention targeting children and parenting practices [abstract]. Pediatric Academic Societies Annual Meeting, May 1-4, 2010, Vancouver, Canada. 2010 CDROM.

Technical Abstract: Prevention-Plus interventions for primary care offer a venue to intervene with both children and parents for child obesity treatment. Such interventions can promote effective parenting practices that encourage healthy eating, physical activity (PA), and lower TV use among children. Test for feasibility an obesity prevention plus intervention targeting children and parenting practices in primary care clinics. A randomized controlled design was used to pilot test 'Helping HAND' targeting 5-8 year old children with BMI 85-99%tile, who were health plan members attending 1 of 4 community clinics. The 6 month program, based on social cognitive and parenting theories, used monthly sessions to work with a parent and child to self select, goal set obesity-related child behaviors, and effective behavior-specific parenting practices to change. Child anthropometrics, PA (via accelerometers), and TV viewing, and parent reported behavior specific parenting practices were measured at baseline and post intervention. Mixed model analyses of variance were used to test for group differences over time while controlling for parent BMI and child age. Three hundred and two families expressed interest in the program, 247 were prescreened, and 40 qualified to participate. Age, BMI, and health plan membership were most common reasons for ineligibility. Sample included 80% girls, mean age 7.2 yrs, mean baseline BMI %tile (Intervention Group (IG) 95.8, sd 3.2; Control Group (CG) 95.9, sd 3.6); 82.5% Hispanic, 12.5% AA, 5% white; and 65% reported income <$30,000. Helping HAND session completion (attending >= 4/6) was 80%, in the IG. Follow–up data has been collected on 82.6% (IG: 17/20, CG 16/20). Preliminary analysis revealed no significant group x time interaction of BMI z-score or percentile, as would be expected in a pilot study. Children in the IG decreased their TV viewing by 6.4 (SE 3.4) hrs/wk, while the CG increased by 1.9 (SE 3.5) hrs/wk. The group x time interaction for TV viewing was F=2.79, df 1, 31 (p=0.105). Helping HAND is feasible to be evaluated in a fully powered RCT, due to little attrition in the pilot study and pilot data showing clinically relevant improvements in some targeted behaviors. Pediatric primary care clinics offer an important site to intervene with overweight children, while simultaneously reaching parents to promote effective parenting practices for healthy lifestyles.