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Understanding Outcomes in Behavior Change Interventions to Prevent Pediatric Obesity: The Role of Dose and Behavior
Meghan M JaKa1, Simone A French2, Julian Wolfson2
11 DC Department of Behavioral Health, Applied Research and Evaluation, Washington, DC, USA.
Insights
Longer phone intervention sessions and parent-led activities between sessions were linked to better pediatric obesity prevention. Focusing on session duration and parent engagement can improve intervention effectiveness.
Area of Science:
- Pediatric obesity prevention
- Behavioral science
- Public health interventions
Background:
- Pediatric obesity interventions yield inconsistent results.
- Understanding intervention "black boxes" is crucial for developing effective strategies.
- Implementation differences impact intervention outcomes.
Purpose of the Study:
- To assess the relationship between phone-based intervention implementation and pediatric obesity outcomes.
- To analyze session length, behavior change techniques, and parent activity implementation.
- To identify key factors for improving pediatric obesity prevention programs.
Main Methods:
- 100 parent-child dyads from a phone-based obesity trial were analyzed.
- Sessions were coded for length and behavior change techniques.
- Parental implementation of between-session activities was parent-reported.
- Child BMI percentile was measured at baseline and 12 months.
Main Results:
- Longer overall session length correlated with decreased child BMI percentile (p = .01).
- Parental implementation of between-session activities was associated with decreased child BMI percentile (p = .02).
- No significant association was found between behavior change techniques used and BMI changes (p = .27).
Conclusions:
- Session length and parent activity implementation are key factors in pediatric obesity prevention.
- Future interventions should prioritize session duration and facilitate parent engagement.
- Optimizing these elements can enhance the effectiveness of obesity prevention programs.
Background:
Behavioral interventions to prevent pediatric obesity have shown inconsistent results across the field. Studying what happens within the "black box" of these interventions and how differences in implementation lead to different outcomes will help researchers develop more effective interventions.
Aim:
To compare the implementation of three features of a phone-based intervention for parents (time spent discussing weight-related behaviors, behavior change techniques used in sessions, and intervention activities implemented by parents between sessions) with study outcomes.
Methods:
A random selection of 100 parent-child dyads in the intervention arm of a phone-based obesity prevention trial was included in this analysis. Sessions were coded for overall session length, length of time spent discussing specific weight-related behaviors, number of behavior change techniques used during the sessions, and number of intervention-recommended activities implemented by the parents between sessions (e.g., parent-reported implementation of behavioral practice/rehearsal between sessions). The primary study outcome, prevention of unhealthy increase in child body mass index (BMI) percentile, was measured at baseline and 12 months.
Results:
Overall session length was associated with decreases in child BMI percentile ( b = -0.02, p = .01). There was no association between the number of behavior change techniques used in the sessions and decreases in child BMI percentile ( b = -0.29, p = .27). The number of activities the parents reported implementing between sessions was associated with decreases in child BMI percentile ( b = -1.25, p = .02).
Discussion:
To improve future interventions, greater attention should be paid to the intended and delivered session length, and efforts should be made to facilitate parents' implementation of intervention-recommended activities between sessions (ClinicalTrials.gov, No. NCT01084590).
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