ARS | Publication request: Effect of parental selection of healthy behavior topic on immediate and delayed plan to change child’s eating or physical activity behavior

Submitted to: Obesity
Publication Type: Abstract Only
Publication Acceptance Date: June 1, 2009
Publication Date: November 1, 2009
Citation: Barlow, S.E., Arceo, D., Fraley, J.K., Butte, N.F. 2009. Effect of parental selection of healthy behavior topic on immediate and delayed plan to change child’s eating or physical activity behavior. Obesity. 17:S120 (Suppl. 2).

Technical Abstract: Recommendations direct pediatricians to address obesity and obesity prevention routinely during well child visits and to tailor their counseling, but clinicians feel ineffective because of time constraints and lack of parent interest. This intervention was designed to maintain the structure of the office visit by prompting parents to select a healthy lifestyle topic to review with the pediatrician during the well child visit and to test the effect of this intervention on a plan to change an eating or activity behavior for their child reported by the parent at visit exit and at 2-month follow-up. In two pediatric offices, all families with children 3-14 years of age scheduled for a well child visit received a letter before the visit encouraging them to choose one or two of 8 topics about healthy eating and physical activity. At the office, parents who enrolled received one or two handouts matching the chosen topics to review with the pediatrician. Visits were otherwise unchanged. In two control offices, the well child visits were conducted as usual. In all four offices each child’s weight and height were recorded, and each parent completed a questionnaire after the visit. In a telephone interview 2-3 months after the visit, parents recalled whether they had planned a change in any of the 8 areas. Of the 520 parents approached, 378 agreed to participate. Intervention and control groups were similar in child’s mean BMI z score. At visit exit, 92.5% of the parents in the intervention group reported plans to change one or more of child’s eating or activity behaviors compared with 69.3% in the control group. This relationship remained significant when adjusted for baseline characteristics: adjusted odds ratio =5.87. 229 families responded to the telephone questionnaire. In intervention group, 28.3% parents accurately recalled their planned area of change compared with 10.6% in the control group. No significant difference was seen based on age, gender, BMI, race-ethnicity, or parent education. Parents prompted to select a lifestyle topic were more likely to plan a change at visit exit and to recall that change at follow-up. This study suggests that a low-burden intervention can motivate some parents to make changes. Further study will evaluate in more detail efforts to change.