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The Impact of a Healthy Weight Intervention Embedded in a Home-Visiting Program on Children's Weight and Mothers'
Alexandra B Morshed1, Rachel G Tabak1, Cynthia D Schwarz1
1Brown School, Washington University in St Louis, St Louis, MO.
Insights
The Healthy Eating and Active Living Taught at Home (HEALTH) intervention did not change preschool children's BMI or maternal feeding habits. However, combined analyses indicated improvements in children's BMI percentile and some feeding practices.
Area of Science:
- Childhood obesity prevention
- Public health interventions
- Maternal and child health
Background:
- The Parents as Teachers (PAT) program previously improved maternal body mass index (BMI) and obesity-related behaviors.
- Preschool-aged children at risk for overweight and their mothers with overweight or obesity were included.
- The Healthy Eating and Active Living Taught at Home (HEALTH) intervention was adapted from the Diabetes Prevention Program.
Purpose of the Study:
- To evaluate the impact of the HEALTH intervention, embedded within the PAT program, on preschool children's BMI and maternal feeding practices.
- To determine if the intervention could build upon previous successes in improving maternal health outcomes.
- To assess changes in children's BMI percentile and z-scores, as well as specific maternal feeding behaviors.
Main Methods:
- A stratified randomized trial was conducted with 179 mother-child dyads.
- The intervention group received the HEALTH program, while the control group received usual PAT care.
- Repeated-measures mixed-ANOVA models were used to analyze differences in outcomes over time.
Main Results:
- The HEALTH intervention showed no significant effect on children's BMI or maternal feeding practices compared to usual care.
- Combined analyses revealed a significant decrease in children's BMI percentile (P=.007).
- BMI z-scores were maintained (P=.19), and 3 out of 8 assessed maternal feeding practices improved (P<.05).
Conclusions:
- The HEALTH intervention, as implemented, did not significantly alter preschool children's BMI or maternal feeding practices.
- Further research with rigorous designs, such as group-randomized trials, is needed to confirm PAT's effectiveness in preventing preschool obesity.
- The HEALTH intervention is suitable for broader implementation to prevent maternal weight gain within the national PAT program.
Objective:
To examine whether a healthy weight intervention embedded in the Parents as Teachers (PAT) home visiting program, which was previously found to improve mothers' body mass index (BMI) and obesity-related behaviors, changed the BMI of preschool children or maternal feeding practices.
Methods:
This stratified randomized trial included preschool-aged children at risk for overweight whose mothers were overweight or had obesity (n = 179). The Healthy Eating and Active Living Taught at Home (HEALTH) intervention was based on the Diabetes Prevention Program. Differences were examined using repeated-measures mixed-ANOVA models.
Results:
Compared with PAT usual care, the HEALTH intervention had no effect on children's BMI or maternal feeding practices. However, combined analyses showed that children's BMI percentile decreased (P = .007), BMI z-scores were maintained (P = .19), and 3 of 8 feeding practices improved over time (P < .05).
Conclusions And Implications:
Additional research is needed to assess the effectiveness of PAT to prevent preschool-age obesity using rigorous designs (eg, group-randomized trials) and to identify its active components. HEALTH is ready to be scaled up to prevent maternal weight gain through embedding within the national PAT program.
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