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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    • "Young children, in particular, are dependent on their parents to ensure that they participate in health promotion behaviours such as limiting their screen time (Bourdeuhuij, 1997; Golan & Crow, 2008; Hingle, O'Conner, Dave, & Baranowski, 2010). The preschool years represent a critical time when children establish health habits that may persist into adolescence and adulthood, and are generally the final years in which parents have primary control over their child's heath behaviours (Hingle et al., 2010; Hodges et al., 2013; Irwin, He, Bouck, Tucker, & Pollet, 2005). It is essential therefore that interventions to limit sedentary behaviour are instituted during this critical period. "
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    ABSTRACT: Objectives: Preschool-aged children spend substantial amounts of time engaged in screen-based activities. As parents have considerable control over their child's health behaviours during the younger years, it is important to understand those influences that guide parents' decisions about their child's screen time behaviours. Design: A prospective design with two waves of data collection, 1 week apart, was adopted. Methods: Parents (n = 207) completed a Theory of Planned Behaviour (TPB)-based questionnaire, with the addition of parental role construction (i.e., parents' expectations and beliefs of responsibility for their child's behaviour) and past behaviour. A number of underlying beliefs identified in a prior pilot study were also assessed. Results: The model explained 77% (with past behaviour accounting for 5%) of the variance in intention and 50% (with past behaviour accounting for 3%) of the variance in parental decisions to limit child screen time. Attitude, subjective norms, perceived behavioural control, parental role construction, and past behaviour predicted intentions, and intentions and past behaviour predicted follow-up behaviour. Underlying screen time beliefs (e.g., increased parental distress, pressure from friends, inconvenience) were also identified as guiding parents' decisions. Conclusion: Results support the TPB and highlight the importance of beliefs for understanding parental decisions for children's screen time behaviours, as well as the addition of parental role construction. This formative research provides necessary depth of understanding of sedentary lifestyle behaviours in young children which can be adopted in future interventions to test the efficacy of the TPB mechanisms in changing parental behaviour for their child's health.
    No preview · Article · Oct 2015 · British Journal of Health Psychology
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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.
    Full-text · Article · May 2015 · Preventive Medicine
    • "Workshops or training focussing on general parenting could be included in interventions in order to address parenting styles, and the impact of these on diet, physical activity and sedentary behaviour in adolescents. Furthermore, interventions should aim to directly involve parents, by specifically requesting their attendance at training, education or counselling sessions, etc., as opposed to using less direct methods such as sending them information, inviting them to events or suggesting their participation in activities with their child (Hingle et al. 2010). Other evidence suggests that interventions to promote healthy behaviours among adolescents should at the very least take parental education status, occupational and income status into consideration. "
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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.
    No preview · Article · Mar 2015 · Child Care Health and Development
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