Parental involvement in interventions to improve child dietary intake: A systematic review

Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
Preventive Medicine (Impact Factor: 3.09). 05/2010; 51(2):103-11. DOI: 10.1016/j.ypmed.2010.04.014
Source: PubMed


Interventions that aim to improve child dietary quality and reduce disease risk often involve parents. The most effective methods to engage parents remain unclear. A systematic review of interventions designed to change child and adolescent dietary behavior was conducted to answer whether parent involvement enhanced intervention effectiveness, and what type of involvement was most effective in achieving desired outcomes.
In 2008, Pub Med, Medline, Psych Info, and Cochrane Library databases were searched to identify programs designed to change child and adolescent dietary intake that also involved parents. Methods of parental involvement were categorized based on the type and intensity of parental involvement. These methods were compared against intervention design, dietary outcomes, and quality of reporting (evaluated using CONSORT checklist) for each study.
The literature search identified 1774 articles and 24 met review criteria. Four studies systematically evaluated parent involvement with inconsistent results. Indirect methods to engage parents were most commonly used, although direct approaches were more likely to result in positive outcomes. Four studies met >70% of CONSORT items.
Limited conclusions may be drawn regarding the best method to involve parents in changing child diet to promote health. However, direct methods show promise and warrant further research.

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Available from: Tom Baranowski, Oct 04, 2015
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    • "It is a general finding that in developed countries, individuals with lower SEP face much higher obesity rates than those with higher education and income, which is true for both adults (Magnusson et al., 2014; McLaren, 2007) and children (de Onis et al., 2010). A number of systematic reviews have looked at interventions aiming to prevent obesity in children (Waters et al., 2011), interventions that involved parents to improve children's weight-related behaviours (Golley et al., 2011), diet (Hingle et al., 2010), PA (O'Connor et al., 2009), and interventions aiming to reduce socioeconomic inequalities in obesity among children (Hillier-Brown et al., 2014; Laws et al., 2014). However, none of these reviews focused on universal (population-based) interventions targeting parents as the main component. "
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    ABSTRACT: The evidence regarding effectiveness of parental support interventions targeting children's health behaviours is weak. We aimed to review: 1) Effectiveness of universal parental support interventions to promote dietary habits, physical activity (PA) or prevent overweight and obesity among children 2-18 years and 2) effectiveness in relation to family socio-economic position. Thirty five studies from 1990-2013 were identified from major databases. Quality was assessed by four criteria accounting for selection and attrition bias, fidelity to intervention, and outcome measurement methodology, categorizing studies as strong, moderate or weak. Four interventions types were identified: Face-to-face counselling, group education, information sent home, and telephone counselling. Face-to-face or telephone counselling was effective in changing children's diet, while there was only weak evidence for improvement in PA. Sending home information was not effective. Concerning body weight, group education seemed more promising than counselling. Intervention effectiveness was generally higher in younger compared to older children. In groups with low socio-economic position, group-based approaches appeared promising. In the future efforts should be made to improve reporting of intervention content, include a power calculation for the main outcome, use of high quality outcome assessment methodology, and a follow-up period of at least 6 months. Copyright © 2015. Published by Elsevier Inc.
    Preventive Medicine 05/2015; 77. DOI:10.1016/j.ypmed.2015.05.005 · 3.09 Impact Factor
    • "✓ ✓ Hingle et al. (2010) Parental involvement in interventions to improve child dietary intake: a systematic review Conduct systematic review of randomized controlled trials designed to prevent obesity, prevent disease and/or promote health in children and adolescents through dietary behaviour changes that involved parents ✓ ✓ Khambalia et al. (2012 A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity Summarize and critically appraise evidence from existing meta-analyses and systematic reviews examining school-based programmes to prevent and control obesity ✓ ✓ Kitzman-Ulrich et al. (2010) The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs Explore the effectiveness of including parenting and family factors in obesity, physical activity, and dietary programmes in youth from elementary school through adolescence ✓ ✓ Krølner et al. (2011) Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies Present a systematic review of qualitative studies of 6–18-year-olds' views and experiences regarding determinants of their intake of fruit and vegetables ✓ ✓ ✓ McLean et al. (2003) Family involvement in weight control, weight maintenance and weight-loss interventions: a systematic review of randomized trials Conduct a descriptive systematic review into the nature and effectiveness of family involvement in weight control, weight maintenance and weight-loss interventions ✓ ✓ Neumark-Sztainer (2005) Preventing the broad spectrum of weight-related problems: working with parents to help teens achieve a healthy weight and a positive body image Present research findings and recommendations on the role of families in preventing weight-related problems in adolescents ✓ ✓ ✓ Neumark-Sztainer (2006) Eating among teens: do family mealtimes make a difference for adolescents' nutrition? "
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    ABSTRACT: The prevalence of non-communicable diseases (NCDs) in adulthood is rapidly increasing, and it is essential that risk factors for NCDs be addressed in adolescence, both for the health of individuals during adolescence and for their health in later life. These risk factors include diet, physical activity and sedentary behaviour. No literature has been published that comprehensively summarizes the impact of social norms and social support on these behaviours among adolescents. Therefore, a scoping review was conducted to determine the extent of recent (since 2000) literature available on this topic. A comprehensive search strategy was used to search PubMed and EMBASE for eligible reviews. Review papers (narrative reviews, systematic and non-systematic reviews) published in English in peer-reviewed journals from 2000 to February 2013 were included in the overview. Two of the authors screened the titles and abstracts of the search results independently. Thirty reviews were included in the scoping review. This scoping review has shown sufficient evidence for parental influences, and especially the positive impact of an authoritative parenting style, on healthy behaviours of adolescents, although the evidence is somewhat more compelling for diet than for physical activity and sedentary behaviour. More research is needed to investigate parental and family influences on physical activity and sedentary behaviour. And the effect of peer influences on diet, physical activity and sedentary behaviour of adolescents requires further investigation. The evidence presented affirms the consideration of social norms and social support in the development of interventions to address these behaviours in adolescents. The evidence regarding parenting style provides some concrete guidance for such interventions. © 2015 John Wiley & Sons Ltd.
    Child Care Health and Development 03/2015; 41(5). DOI:10.1111/cch.12241 · 1.69 Impact Factor
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    • "Since parents are fundamental to the success of any child intervention, parents were involved in Health-E-PALS both through direct (via meetings and health fairs) and indirect exposure to the programme’s elements, by sending information packets and recipes home with the students. It is worth noting that direct methods to engage parents have proven to be more successful than indirect methods [46] although the best way to involve parents is yet unknown. Parents helped in the success of the Health-E-PALS intervention by ensuring the availability and accessibility of healthier food options at home, and through role modelling. "
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    ABSTRACT: Background: In Lebanon, childhood obesity doubled during the past decade. Preventive measures should start early in life and Schools are considered an important environment to promote energy balance health behaviours. School-based programmes promoting healthy lifestyles are lacking. The purpose of this study was to evaluate the feasibility and effectiveness of a multicomponent school-based intervention to promote healthy eating and physical activity (and prevent obesity) with school children aged 9-11 years in Lebanon. Methods: The intervention was developed based on the constructs of the Social Cognitive Theory and adapted to the culture of Lebanese and Arab populations. It consisted of three components: class curriculum, family involvement and food service. Eight schools were purposively selected from two communities of different socioeconomic status (SES) in Beirut and, within each school type, were matched on SES, religious sect profile, and then randomly assigned to either the intervention or control group. Anthropometric measurements and questionnaires on determinants of behavioural change, eating and physical activity habits were completed by the students in both groups at baseline and post intervention. Focus group interviews were conducted in intervention schools at the end of the study. Challenges encountered during the programme implementation were also identified, since Lebanon is considered a country with political unrest and no similar research projects were conducted in the area. Results: Students in the intervention group reported purchasing and consuming less chips and sweetened drinks post-intervention compared with controls (86% & 88% less respectively p < 0.001). Knowledge and self-efficacy scores increased for the intervention (+2.8 & +1.7 points respectively p < 0.001) but not for the control group. There was no difference in physical activity and screen time habits and no changes in BMI between groups at post intervention. Interview data from focus groups showed that the programme was generally well accepted. Limitations for better outcomes include the length of the programme and the school environment. Conclusion: "Health-E-PALS" intervention is a promising innovative, theory-based, culturally sensitive intervention to promote healthy eating habits and physical activity in Lebanese school children with a potential to be scaled up, replicated and sustained.
    BMC Public Health 09/2014; 14(1):940. DOI:10.1186/1471-2458-14-940 · 2.26 Impact Factor
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