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Participant characteristics and intervention processes associated with reductions in television viewing in the High
Elizabeth M Cespedes1, Christine M Horan2, Matthew W Gillman3
1Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Objective:
To evaluate the High Five for Kids intervention effect on television within subgroups, examine participant characteristics associated with process measures and assess perceived helpfulness of television intervention components.
Method:
High Five (randomized controlled trial of 445 overweight/obese 2-7 year-olds in Massachusetts [2006-2008]) reduced television by 0.36 h/day. 1-year effects on television viewing, stratified by subgroup, were assessed using linear regression. Among intervention participants (n=253), associations of intervention component helpfulness with television reduction were examined using linear regression and associations of participant characteristics with processes linked to television reduction (choosing television and completing intervention visits) were examined using logistic regression.
Results:
High Five reduced television across subgroups. Parents of Latino (versus white) children had lower odds of completing ≥2 study visits (Odds Ratio: 0.39 [95% Confidence Interval: 0.18, 0.84]). Parents of black (versus white) children had higher odds of choosing television (Odds Ratio: 2.23 [95% Confidence Interval: 1.08, 4.59]), as did parents of obese (versus overweight) children and children watching ≥2 h/day (versus <2) at baseline. Greater perceived helpfulness was associated with greater television reduction.
Conclusion:
Clinic-based motivational interviewing reduces television viewing in children. Low cost education approaches (e.g., printed materials) may be well-received. Parents of children at higher obesity risk could be more motivated to reduce television.
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