Two-Year Outcomes of the Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal
Adam P Knowlden1, Eric Conrad1
11 University of Alabama, Tuscaloosa, AL, USA.
Insights
Web-based interventions can help prevent childhood obesity. The EMPOWER program, which involved mothers, showed sustained improvements in children's fruit and vegetable intake over two years.
Area of Science:
- Public Health
- Pediatrics
- Behavioral Science
Background:
- Childhood overweight and obesity is a significant public health issue.
- Web-based interventions offer a scalable approach to combatting childhood obesity.
- Sustained effects of such interventions are crucial for long-term impact.
Purpose of the Study:
- To evaluate the sustained effects of a web-based, maternal-facilitated childhood obesity prevention intervention (EMPOWER) at the 2-year postintervention mark.
- To assess the intervention's capacity to improve child dietary and physical activity behaviors.
Main Methods:
- A randomized controlled trial compared the EMPOWER intervention (social cognitive theory-based, n=29) with a knowledge-based control (Healthy Lifestyles, n=28).
- The EMPOWER intervention targeted four key child behaviors: fruit/vegetable consumption, physical activity, sugar-free beverage intake, and screen time.
- Maternal-facilitated behaviors were central to the EMPOWER intervention's design.
Main Results:
- A significant group-by-time interaction was found for child fruit and vegetable consumption (p=.033), with small effect size.
- The maternal-facilitated environment construct positively correlated with improved child fruit and vegetable intake.
- Both groups showed significant improvements in physical activity, sugar-free beverage intake, and screen time over time.
Conclusions:
- The EMPOWER intervention led to a sustained increase in children's fruit and vegetable consumption (1.680 cups/day relative to control).
- Web-based, maternal-facilitated interventions demonstrate potential for inducing lasting behavioral changes in children.
- These findings support the efficacy of digital health strategies in pediatric obesity prevention.
Background:
Childhood overweight and obesity is a public health epidemic with far-reaching medical, economic, and quality of life consequences. Brief, web-based interventions have received increased attention for their potential to combat childhood obesity. The purpose of our study was to evaluate a web-based, maternal-facilitated childhood obesity prevention intervention dubbed Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER), for its capacity to elicit sustained effects at the 2-year postintervention follow-up mark.
Method:
Two interventions were evaluated using a randomized controlled trial design. The experimental, EMPOWER arm received a social cognitive theory intervention ( n = 29) designed to improve four maternal-facilitated behaviors in children (fruit and vegetable consumption, physical activity, sugar-free beverage intake, screen time). The active control arm received a knowledge-based intervention dubbed Healthy Lifestyles ( n = 28), which also targeted the same four behaviors.
Results:
We identified a significant group-by-time interaction of small effect size for child fruit and vegetable consumption ( p = .033; Cohen's f = 0.139) in the EMPOWER group. The construct of maternal-facilitated environment was positively associated to improvements in child fruit and vegetable behavior. We also found significant main effects for child physical activity ( p = .024; Cohen's f = 0.124); sugar-free beverage intake ( p < .001; Cohen's f = 0.321); and screen time ( p < .001; Cohen's f = 0.303), suggesting both groups improved in these behaviors over time.
Conclusions:
The EMPOWER arm of the trial resulted in an overall increase of 1.680 daily cups of fruits and vegetables consumed by children, relative to the comparison group ( p < .001, 95% confidence interval = [1.113, 2.248]). Web-based maternal-facilitated interventions can induce sustained effects on child behaviors.
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