- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01538615
Healthy Home Offerings Via the Mealtime Environment (HOME) Plus
February 27, 2018 updated by: University of Minnesota
The goal of the proposed project is to see if an innovative family-based intervention can reduce childhood obesity by actively engaging the whole family in promoting healthy behaviors in the home.
In additions, the project will also examine how the HOME Plus family intervention influences children's dietary intake, frequency of family meals, availability of healthy and unhealthy foods in the home and served at meals and snacks, and screen time (TV, game systems).
The study will provide important information on strategies that families can use at home to prevent obesity.
Study Overview
Detailed Description
Childhood obesity is a serious public health problem with limited effective prevention strategies to date.
Although previous nutrition and physical activity environmental approaches for obesity prevention show some promise, most studies have not shown reductions in excess weight gain.
Moreover, few prevention studies significantly engage parents and focus on the home environment.
To prevent childhood obesity it is essential to promote healthy behaviors in the home environment because parents are influential primary role models for healthy eating and sedentary behavior, and are gatekeepers for food and beverage availability and degree of inactivity within the home.
Moreover, the home setting is where most of children's calories and energy dense foods are consumed and where children engage in much of their sedentary behavior, particularly screen time (e.g., television, computer, game system).
The proposed study will test the efficacy of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus program, a ten-month, family-based health promotion intervention to prevent excess weight gain among 8-12 year old children.
The program is based on Social Cognitive Theory and a socio-ecological framework and promotes both regular and nutritionally-sound snacks and meals in which family members eat together (i.e., family meals) and encourages reductions in sedentary behavior, particularly screen time among children in the home setting.
The efficacy of the intervention will be tested in a randomized controlled trial with 160 families randomized to two conditions (intervention or attention-only control).
Two cohorts of families, recruited from after-school programs and community centers, will be followed for 2.5 years.
The primary hypothesis is that, by the end of the ten month intervention, target children in the intervention families, relative to children in the control families, will have significantly lower body mass index (BMI; primary outcome) after adjustment for baseline BMI values.
Secondary outcomes include frequency of weekly family meals and number of healthful foods and beverages available in the home and served at family meals and snacks (as reported by parent), target children's daily intakes of healthful foods and beverages, and target children's minutes of sedentary behavior per week, particularly screen time.
Child and parent measurement will occur in their homes at baseline, post-intervention (12-months post-randomization), and follow-up (9-months post-intervention) by trained research staff.
The proposed study builds upon successful methods from our HOME pilot study (2006-2008; NIH R21-DK0072997) and is innovative as it actively engages entire families in experiential activities and capitalizes on the home setting.
The study will provide important information on environmental and behavioral strategies that families can use at home to prevent excess weight gain.
The intervention program has high translation potential and is likely to be immediately useful to families of school-age children because it will be tested in real-world community settings and sustained across the state of Minnesota by the University of Minnesota's Extension Service.
Study Type
Interventional
Enrollment (Actual)
413
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Minnesota
-
Minneapolis, Minnesota, United States, 55455
- University of Minnesota, School of Nursing
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
8 years and older (Child, Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- the target child is between the ages of 8-12 years
- the target adult parent or guardian is the primary food preparer in the home
- target child has an age and gender adjusted body mass index at or above the 50th percentile
- participants are willing to be randomized into one of two groups (intervention or control)
- target child must live with participating adult most of the time
Exclusion Criteria:
- participants plan to move out of the area in the next six months
- participants have a severe food allergy, limitation, or medical condition that prevents them from participating in the intervention
- participants do not speak and read in English
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: HOME Plus Intervention
described below
|
The HOME Plus program families will participate in monthly, two-hour group sessions for ten months at local community centers.
Each session offers new ideas focusing on family meals, healthy eating, and reducing sedentary behavior.
At each session, families prepare and eat a meal together and participate in small group discussions and activities for both parent and child groups to promote healthy behaviors in the home.
Topics include planning healthy meals and snacks with your family, having meals with your family more often, and improving the healthfulness of the food available at home.
Families also receive periodic supportive phone calls throughout the year using motivational interviewing techniques to promote healthy behaviors to prevent and reduce childhood obesity.
|
|
No Intervention: Control
Control participants receive a monthly newsletter for the 10 months of the study with tips on healthy eating.
The topics do not overlap the intervention content.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Child Body Mass Index (BMI Z-score)
Time Frame: Change from Baseline at 12 and 21 months
|
Trained study staff will measure parent and child height and weight and use this to calculate body mass index (BMI).
BMI values were than standardized for age and gender using CDC guidelines to obtain BMI z-scores.
Analyses controlled for child age and parent education at baseline.
|
Change from Baseline at 12 and 21 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Target Children's Daily Intakes of Fruits and Vegetables
Time Frame: Change from Baseline at 12 and 21 months
|
A trained interviewer will complete three 24-hour dietary recalls at each data collection time point with the child.
The three days will be averaged to get an estimate of usual intake.
Analyses controlled for child age and parent education at baseline.
|
Change from Baseline at 12 and 21 months
|
|
Change in Target Children's Hours of Screen Time (Television Viewing, Video and Computer Game Playing) Per Week
Time Frame: Change from Baseline at 12 and 21 months
|
Screen time will be measured with survey questions asking children how many hours per day they spend doing each sedentary activity (such as watching TV, using the computer, playing video games).
Separate questions will be asked for week days and weekend days then the will be weighted to determine the hours of sedentary activity per week.
Analyses controlled for child age and parent education at baseline.
|
Change from Baseline at 12 and 21 months
|
|
Change in Number of Fruits and Vegetables Available in the Home
Time Frame: Change from Baseline at 12 and 21 months
|
The HOME Food Inventory assesses which foods families currently have in their home from a list of items.
Analyses controlled for child age and parent education.
|
Change from Baseline at 12 and 21 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Jayne A Fulkerson, PhD, University of Minnesota, School of Nursing
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Fulkerson JA, Neumark-Sztainer D, Story M, Gurvich O, Kubik MY, Garwick A, Dudovitz B. The Healthy Home Offerings via the Mealtime Environment (HOME) Plus study: design and methods. Contemp Clin Trials. 2014 May;38(1):59-68. doi: 10.1016/j.cct.2014.01.006. Epub 2014 Jan 27.
- Draxten M, Fulkerson JA, Friend S, Flattum CF, Schow R. Parental role modeling of fruits and vegetables at meals and snacks is associated with children's adequate consumption. Appetite. 2014 Jul;78:1-7. doi: 10.1016/j.appet.2014.02.017. Epub 2014 Mar 12.
- Friend S, Fulkerson JA, Neumark-Sztainer D, Garwick A, Flattum CF, Draxten M. Comparing childhood meal frequency to current meal frequency, routines, and expectations among parents. J Fam Psychol. 2015 Feb;29(1):136-40. doi: 10.1037/fam0000046. Epub 2014 Dec 8.
- Flattum C, Draxten M, Horning M, Fulkerson JA, Neumark-Sztainer D, Garwick A, Kubik MY, Story M. HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity. Int J Behav Nutr Phys Act. 2015 Apr 29;12:53. doi: 10.1186/s12966-015-0211-7.
- Fulkerson JA, Friend S, Flattum C, Horning M, Draxten M, Neumark-Sztainer D, Gurvich O, Story M, Garwick A, Kubik MY. Promoting healthful family meals to prevent obesity: HOME Plus, a randomized controlled trial. Int J Behav Nutr Phys Act. 2015 Dec 15;12:154. doi: 10.1186/s12966-015-0320-3.
- Horning ML, Fulkerson JA, Friend SE, Neumark-Sztainer D. Associations among Nine Family Dinner Frequency Measures and Child Weight, Dietary, and Psychosocial Outcomes. J Acad Nutr Diet. 2016 Jun;116(6):991-9. doi: 10.1016/j.jand.2015.12.018. Epub 2016 Feb 10.
- Draxten M, Flattum C, Fulkerson J. An Example of How to Supplement Goal Setting to Promote Behavior Change for Families Using Motivational Interviewing. Health Commun. 2016 Oct;31(10):1276-83. doi: 10.1080/10410236.2015.1062975. Epub 2016 Mar 3.
- Loth KA, Friend S, Horning ML, Neumark-Sztainer D, Fulkerson JA. Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes. Appetite. 2016 Dec 1;107:188-195. doi: 10.1016/j.appet.2016.07.036. Epub 2016 Jul 31.
- Horning ML, Fulkerson JA, Friend SE, Story M. Reasons Parents Buy Prepackaged, Processed Meals: It Is More Complicated Than "I Don't Have Time". J Nutr Educ Behav. 2017 Jan;49(1):60-66.e1. doi: 10.1016/j.jneb.2016.08.012. Epub 2016 Oct 12.
- Kubik MY, Gurvich OV, Fulkerson JA. Association Between Parent Television-Viewing Practices and Setting Rules to Limit the Television-Viewing Time of Their 8- to 12-Year-Old Children, Minnesota, 2011-2015. Prev Chronic Dis. 2017 Jan 19;14:E06. doi: 10.5888/pcd14.160235.
- Lee J, Kubik MY, Fulkerson JA, Kohli N, Garwick AE. The Identification of Family Social Environment Typologies Using Latent Class Analysis: Implications for Future Family-Focused Research. J Fam Nurs. 2020 Feb;26(1):26-37. doi: 10.1177/1074840719894016. Epub 2019 Dec 25.
- Lee J, Kubik MY, Fulkerson JA. Diet Quality and Fruit, Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months. J Acad Nutr Diet. 2019 Oct;119(10):1695-1702. doi: 10.1016/j.jand.2019.03.004. Epub 2019 May 2.
- Arcan C, Friend S, Flattum CF, Story M, Fulkerson JA. Fill "half your child's plate with fruits and vegetables": Correlations with food-related practices and the home food environment. Appetite. 2019 Feb 1;133:77-82. doi: 10.1016/j.appet.2018.10.017. Epub 2018 Oct 17.
- Myers ML, Fulkerson JA, Friend SE, Horning ML, Flattum CF. Case study: Behavior changes in the family-focused obesity prevention HOME Plus program. Public Health Nurs. 2018 Jul;35(4):299-306. doi: 10.1111/phn.12403. Epub 2018 Apr 6.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
July 1, 2010
Primary Completion (Actual)
July 1, 2015
Study Completion (Actual)
June 1, 2016
Study Registration Dates
First Submitted
January 17, 2012
First Submitted That Met QC Criteria
February 20, 2012
First Posted (Estimate)
February 24, 2012
Study Record Updates
Last Update Posted (Actual)
March 1, 2018
Last Update Submitted That Met QC Criteria
February 27, 2018
Last Verified
January 1, 2018
More Information
Terms related to this study
Other Study ID Numbers
- 20521
- R01DK084000-01A2 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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