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: 7.86). 02/2011; 12(2):114-30. DOI: 10.1111/j.1467-789X.2010.00745.x
Source: PubMed

ABSTRACT 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.


Available from: Amy Slater, Apr 27, 2015
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    ABSTRACT: To develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in Swedish children. A cluster-randomised controlled trial was carried out in areas with low to medium socio-economic status. Participants were six-year-old children (n = 243) and their parents. Fourteen pre-school classes were randomly assigned to intervention (n = 7) and control groups (n = 7). The intervention lasted for 6 months and included: 1) Health information for parents, 2) Motivational Interviewing with parents and 3) Teacher-led classroom activities with children. Physical activity was measured by accelerometry, dietary and physical activity habits and parental self-efficacy through a questionnaire. Body weight and height were measured and BMI standard deviation score was calculated. Measurements were conducted at baseline, post-intervention and at 6-months follow-up. Group differences were examined using analysis of covariance and Poisson regression, adjusted for gender and baseline values. There was no significant intervention effect in the primary outcome physical activity. Sub-group analyses showed a significant gender-group interaction in total physical activity (TPA), with girls in the intervention group demonstrating higher TPA during weekends (p = 0.04), as well as in sedentary time, with boys showing more sedentary time in the intervention group (p = 0.03). There was a significantly higher vegetable intake (0.26 servings) in the intervention group compared to the control group (p = 0.003). At follow-up, sub-group analyses showed a sustained effect for boys. The intervention did not affect the prevalence of overweight or obesity. It is possible to influence vegetable intake in children and girls' physical activity through a parental support programme. The programme needs to be intensified in order to increase effectiveness and sustain the effects long-term. These findings are an important contribution to the further development of evidence-based parental support programmes to prevent overweight and obesity in children. ISRCTN32750699.
    PLoS ONE 02/2015; 10(2):e0116876. DOI:10.1371/journal.pone.0116876 · 3.53 Impact Factor
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    ABSTRACT: Background This umbrella review aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviors. Applying the World Health Organization¿s framework, we sought for 3 types of characteristics, reflecting: (1) main intervention/policy characteristics, referring to the design, targets, and participants, (2) monitoring and evaluation processes, and (3) implementation issues. This investigation was undertaken by the DEDPIAC Knowledge Hub (the Knowledge Hub on the DEterminants of DIet and Physical ACtivity), which is an action of the European Union¿s joint programming initiative.MethodsA systematic review of reviews and stakeholder documents was conducted. Data from 7 databases was analyzed (99 documents met inclusion criteria). Additionally, resources of 7 major stakeholders (e.g., World Health Organization) were systematically searched (10 documents met inclusion criteria). Overall, the review yielded 74 systematic reviews, 16 position review papers, and 19 stakeholders¿ documents. Across characteristics, 25% were supported by¿¿¿4 systematic reviews. Further, 25% characteristics were supported by¿¿¿3 stakeholders¿ documents. If identified characteristics were included in at least 4 systematic reviews or at least 3 stakeholders¿ documents, these good practice characteristics were classified as relevant.ResultsWe derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy (n¿=¿18) fell into 6 categories: the use of theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics (n¿=¿18) were grouped into 6 categories: costs/funding, outcomes, evaluation of effects, time/effect size, reach, the evaluation of participation and generalizability, active components/underlying processes. Implementation characteristics (n¿=¿17) were grouped into eight categories: participation processes, training for practitioners, the use/integration of existing resources, feasibility, maintenance/sustainability, implementation partnerships, implementation consistency/adaptation processes, transferability.Conclusions The use of the proposed list of 53 good practice characteristics may foster further development of health promotion sciences, as it would allow for identification of success vectors in the domains of main characteristics of interventions/policies, their implementation, evaluation and monitoring processes.
    BMC Public Health 01/2015; 15(1):19. DOI:10.1186/s12889-015-1354-9 · 2.32 Impact Factor
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    ABSTRACT: Dietary habits and physical activity are often the focus of obesity prevention programmes and involving parents in such programmes has proven to be effective. The aims of this study were to describe parents' concerns about their children's diet and physical activity habits and to describe barriers to change. The study used archival data gathered unobtrusively in the form of memos taken after sessions of Motivational Interviewing as part of the parental support programme A Healthy School Start. The 74 MI-sessions were conducted from October 2010 to April 2011 with either a mother or father or both, all with children in pre-school class. Thematic analysis was applied. Three themes were identified regarding children's dietary habits: amount of food consumed influenced by behaviour in the family, eating situations influenced by stressful everyday life and family interplay, and food choices influenced by stressful everyday life and family interplay. One theme appeared regarding physical activity: physical activity influenced by stressful everyday life and family interplay. Family interplay appears to be an important link between the work-life stress perceived by parents and less healthy food and physical activity habits in the home. Both lack of parental cooperation and negative parent-child interactions may act as barriers to healthy eating and physical activity and should be addressed in future intervention studies on health-related behaviours of children. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Appetite 12/2014; 87. DOI:10.1016/j.appet.2014.12.208 · 2.52 Impact Factor