Interventions that involve parents to improve children's weight-related nutrition intake and activity patterns—What nutrition and activity targets and behaviour change techniques are associated with intervention effectiveness?

CSIRO Food and Nutritional Sciences, The Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia.
Obesity Reviews (Impact Factor: 8). 02/2011; 12(2):114-30. DOI: 10.1111/j.1467-789X.2010.00745.x
Source: PubMed


Parent involvement is an important component of obesity prevention interventions. However, the best way to support parents remains unclear. This review identifies interventions targeting parents to improve children's weight status, dietary and/or activity patterns, examines whether intervention content and behaviour change techniques employed are associated with effectiveness. Seventeen studies, in English, 1998-2008, were included. Studies were evaluated by two reviewers for study quality, nutrition/activity content and behaviour change techniques using a validated quality assessment tool and behaviour change technique taxonomy. Study findings favoured intervention effectiveness in 11 of 17 studies. Interventions that were considered effective had similar features: better study quality, parents responsible for participation and implementation, greater parental involvement and inclusion of prompt barrier identification, restructure the home environment, prompt self-monitoring, prompt specific goal setting behaviour change techniques. Energy intake/density and food choices were more likely to be targeted in effective interventions. The number of lifestyle behaviours targeted did not appear to be associated with effectiveness. Intervention effectiveness was favoured when behaviour change techniques spanned the spectrum of behaviour change process. The review provides guidance for researchers to make informed decisions on how best to utilize resources in interventions to support and engage parents, and highlights a need for improvement in intervention content reporting practices.

Download full-text


Available from: Amy Slater,
  • Source
    • "However, another study found no differences in food availability, accessibility or affordability by SES (Turrell, Blakely, Patterson, & Oldenburg, 2004). Given that cost is a major influence on food purchases (Van der Kruk et al., 2013; Golley et al., 2011) and that lower SES groups are likely to have less disposable income, it's quite likely that healthier (often more expensive) foods may be overlooked in favour of more unhealthy, energy-dense choices (Giskes et al., 2002; Hunter et al., 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose The purpose of this qualitative study was to explore the perceptions and attitudes that underlie food choices, and, the impact of a school-based healthy eating intervention in mothers from an economically-disadvantaged community. The aim of the intervention was to educate children to act as ‘health messengers’ to their families. Method Sixteen semi-structured phone interviews were conducted with mothers with four receiving a second interview. Interviews were conducted following their child’s participation in a six-week after school healthy cooking intervention. Results Thematic content analysis revealed four main themes: Cost and budget influence on food choices, diversity in household rules controlling food, role of socialisation on diet, and improved cooking skills and confidence to make homemade meals. The interview findings demonstrated the positive influence of the after-school cooking intervention on children and their families in cooking skills, promoting healthier cooking methods and increasing confidence to prepare homemade meals. Conclusions The findings demonstrated the wider economic and social influences on food choices and eating practices. Socialisation into, and strong cultural norms around, eating habits were significant influences on family diet and on parental decisions underpinning food choices and attitudes towards the control of food within the family. The intervention was perceived to be successful in terms of improving nutritional knowledge, cooking skills and increasing confidence to make healthy and tasty homemade meals. The study demonstrates the importance of parental involvement in school-based interventions if improvements in healthy eating are to be evidenced at the family level and maintained.
    Eating Behaviors 01/2016; In press. DOI:10.1016/j.eatbeh.2015.11.001 · 1.58 Impact Factor
  • Source
    • "The apps were rated based on the taxonomy of behavior change techniques used in interventions [14]. This taxonomy was developed to identify potentially effective behavior change techniques used in interventions [14] and was previously used to identify behavior change techniques in interventions that aimed to increase physical activity [7],[14],[15],[22]. The taxonomy distinguished 26 behavior change techniques. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background In May 2013, the iTunes and Google Play stores contained 23,490 and 17,756 smartphone applications (apps) categorized as Health and Fitness, respectively. The quality of these apps, in terms of applying established health behavior change techniques, remains unclear.Methods The study sample was identified through systematic searches in iTunes and Google Play. Search terms were based on Boolean logic and included AND combinations for physical activity, healthy lifestyle, exercise, fitness, coach, assistant, motivation, and support. Sixty-four apps were downloaded, reviewed, and rated based on the taxonomy of behavior change techniques used in the interventions. Mean and ranges were calculated for the number of observed behavior change techniques. Using nonparametric tests, we compared the number of techniques observed in free and paid apps and in iTunes and Google Play.ResultsOn average, the reviewed apps included 5 behavior change techniques (range 2¿8). Techniques such as self-monitoring, providing feedback on performance, and goal-setting were used most frequently, whereas some techniques such as motivational interviewing, stress management, relapse prevention, self-talk, role models, and prompted barrier identification were not. No differences in the number of behavior change techniques between free and paid apps, or between the app stores were found.Conclusions The present study demonstrated that apps promoting physical activity applied an average of 5 out of 23 possible behavior change techniques. This number was not different for paid and free apps or between app stores. The most frequently used behavior change techniques in apps were similar to those most frequently used in other types of physical activity promotion interventions.
    International Journal of Behavioral Nutrition and Physical Activity 07/2014; 11(1):97. DOI:10.1186/s12966-014-0097-9 · 4.11 Impact Factor
  • Source
    • "Childhood overweight and obesity are rapidly increasing public health problems [1]. Preventive interventions are increasingly being aimed at parents of overweight children, [2] who are responsible for a substantial part of their children’s nutrition and physical activity behaviours. However, parents often fail to recognize their child as overweight [3,4]: a systematic review on parents’ perceptions of their children’s weight status showed that more than half of the parents of overweight children underestimate their child’s overweight, perceiving their child as normal weight [5]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Parents often fail to correctly perceive their children's weight status, but no studies have examined the association between parental weight status perception and longitudinal BMIz change (BMI standardized to a reference population) at various ages. We investigated whether parents are able to accurately perceive their child's weight status at age 5. We also investigated predictors of accurate weight status perception. Finally, we investigated the predictive value of accurate weight status perception in explaining children's longitudinal weight development up to the age of 9, in children who were overweight at the age of 5. We used longitudinal data from the KOALA Birth Cohort Study. At the child's age of 5 years, parents filled out a questionnaire regarding child and parent characteristics and their perception of their child's weight status. We calculated the children's actual weight status from parental reports of weight and height at ages 2, 5, 6, 7, 8, and 9 years. Regression analyses were used to identify factors predicting which parents accurately perceived their child's weight status. Finally, regression analyses were used to predict subsequent longitudinal BMIz change in overweight children. Eighty-five percent of the parents of overweight children underestimated their child's weight status at age 5. The child's BMIz at age 2 and 5 were significant positive predictors of accurate weight status perception (vs. underestimation) in normal weight and overweight children. Accurate weight status perception was a predictor of higher future BMI in overweight children, corrected for actual BMI at baseline. Children of parents who accurately perceived their child's weight status had a higher BMI over time, probably making it easier for parents to correctly perceive their child's overweight. Parental awareness of the child's overweight as such may not be sufficient for subsequent weight management by the parents, implying that parents who recognize their child's overweight may not be able or willing to adequately manage the overweight.
    BMC Public Health 03/2014; 14(1):291. DOI:10.1186/1471-2458-14-291 · 2.26 Impact Factor
Show more