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Universal childhood obesity prevention in a rural community: Study design, methods and baseline participant

Jayne A Fulkerson¹, Melissa L Horning¹, Daheia J Barr-Anderson²

¹School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.

Contemporary Clinical Trials

|October 1, 2020

Insights

Childhood obesity prevention is crucial in rural areas. The New Ulm at HOME (NU-HOME) study used a family-centered approach to promote healthy eating and activity, showing promise for preventing excess weight gain in rural children.

Area of Science:

Public Health
Pediatrics
Nutrition Science

Background:

Childhood obesity is a significant public health issue, with rural children facing higher risks.
Limited research exists on family-based, community-engaged obesity prevention programs for rural school-aged children.
Existing interventions often overlook the unique needs of rural populations and the importance of family-centered approaches.

Purpose of the Study:

To test the efficacy of the New Ulm at HOME (NU-HOME) family meals-focused program in preventing excess weight gain among rural school-aged children.
To adapt and implement a previously successful urban intervention for a rural setting through community collaboration.
To evaluate the impact of a family-centered intervention on child body mass index (BMI) z-score, body fat, and overweight/obesity incidence.

Main Methods:

A randomized controlled trial (RCT) involving 114 parent/child dyads in rural Minnesota.
A two-arm study comparing an intervention group with a wait-list control group.
The intervention included monthly in-person family sessions and motivational phone calls for parents, focusing on family meals, physical activity, and home environment.

Main Results:

Primary outcomes measured included changes in child BMI z-score, percent body fat, and incidence of overweight and obesity.
Secondary outcomes assessed included home food/beverage availability, family meal patterns, dietary intake quality (HEI-2015), physical activity levels, and screen time.
The study aimed to rigorously evaluate the intervention's effectiveness in a real-world rural community setting.

Conclusions:

The NU-HOME study demonstrated a collaborative model for childhood obesity prevention in rural communities.
The family-centered, community-engaged intervention holds potential for addressing weight gain in rural school-aged children.
Future research should build upon this model to further combat childhood obesity in underserved rural populations.

Read full analysis

Abstract:

Childhood obesity is a major health concern in the United States (US) and those living in rural communities are at higher risk than their urban counterparts. Few prevention trials have engaged whole families of school-age children in community settings, and none to date have promoted family meals, family activity and healthful home environments in rural settings through a rigorous, randomized controlled trial (RCT). The New Ulm at HOME (NU-HOME) study recruited 114 parent/child dyads in a two-arm (intervention versus wait-list control) RCT to test the efficacy of a family meals-focused program aimed to prevent excess weight gain among 7-10 year-old children in rural Minnesota. The NU-HOME program was adapted from a previously tested program for urban families through a unique community collaboration. The program included 7 monthly in-person sessions for all family members. Parents also participated in 4 motivational goal-setting phone calls. The primary outcome measures were age- and sex-adjusted child body mass index (BMI) z-score, percent body fat, and incidence of overweight and obesity post-intervention. Secondary outcomes included quality of food and beverage availability in the home; family meals and snacks; children's dietary intake quality (e.g., Healthy Eating Index (HEI)-2015, fruits and vegetables, sugar-sweetened beverages, snacks); and children's screen time and weekly minutes of moderate-to-vigorous physical activity, total physical activity, and sedentary behavior. The NU-HOME RCT was a collaborative effort of academic and health system researchers, interventionists and community leaders that aimed to prevent childhood obesity in rural communities through engagement of the whole family in an interactive intervention.

Keywords:

Family Family meals Home Intervention Obesity Rural

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