Online Videos and New Feeding Content to Enhance a Current EFNEP Program

Use of Engaging Online Videos in Conjunction With New Feeding Content to Enhance a Current EFNEP Program in the Prevention of Child Obesity

The goal of this study is to further increase the impact of a validated and widely-used Eating Smart • Being Active EFNEP curriculum by teaching parents responsive feeding practices resulting in the development of healthier patterns of child eating behavior and food intake. Additionally, the effectiveness of two delivery strategies for adding feeding video-based content will be examined (in-person versus online lessons).

Study Overview

• Status: Completed
• Conditions: Obesity, Childhood
• Intervention / Treatment: Behavioral: Nutrition program with in-person parental feeding content; Behavioral: Nutrition program with online parental feeding content

Detailed Description

During Phase I of the project (first two years), the leadership team composed of both research and extension investigators will work with the media production team to edit the SEEDS videotapes to meet the needs of the current project and to develop the website and activities for use in the online condition. Phase II (second three years) will be a large scale evaluation of this program. In this phase, classes of EFNEP participants in Colorado and Washington will be randomly assigned to one of three conditions: 1) Eating Smart • Being Active alone (control); 2) Eating Smart • Being Active plus feeding videos at the weekly EFNEP sessions, plus facilitated group discussion (in-person); or 3) Eating Smart • Being Active plus online videos and activities, (online). Pre- and post-program assessments, 6- and 12-month follow ups will be conducted to assess responsive feeding, providing structure, food exploration, child eating behaviors, parent knowledge, and child dietary intake. Child dietary intake will be obtained on a sub-sample of 90 participants. In Phase III, the investigators will begin dissemination.

A total of 543 participants were recruited in five locations to participate in the project: 262 from three counties in Colorado and 281 from three counties in Washington (English and Spanish participants). A total of 4 to 10 mothers were recruited for each group. After recruitment, groups were randomly assigned to the three conditions ensuring a relatively equal number of participants per condition.

Data from children who have any kind of food allergies or diabetes or are on special diet will be excluded from the analyses.

To ensure program fidelity, program educators will complete implementation checklists, and 20% of the sessions will be attended by an additional grant staff member to conduct implementation observations and assess participant engagement. Detailed records of participant attendance will be collected to assess dosage effects and attrition. All assessments will be conducted by grant project staff blind to the group status of the participants. Retention of participants will be maximized using strategies such as obtaining multiple phone numbers for each family; obtaining external contact information for siblings and close friends; sending interim reminders with the goal of fostering contact should the family move; and phone calls, emails or letters between data collection points to each family.

• Study Type: Interventional
• Enrollment (Actual): 543
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Colorado
    • Fort Collins, Colorado, United States, 80523
      • Colorado State University
  • Washington
    • Pullman, Washington, United States, 99164
      • Washington State University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Parents who attend EFNEP programs in the states of WA and CO.

Exclusion Criteria:

• Parents with children younger than age 2 and older than age 8 will be excluded.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Participants will receive a nutrition program without parental feeding content. They will attend the nutrition program (Eating Smart • Being Active).
Experimental: In-person; Nutrition program with in-person parental feeding content.	Behavioral: Nutrition program with in-person parental feeding content; Participants will attend the nutrition program (Eating Smart • Being Active) and be provided with in-person parental feeding content.
Experimental: Online; Nutrition program with online parental feeding content.	Behavioral: Nutrition program with online parental feeding content; Participants will attend the nutrition program (Eating Smart • Being Active). They will access parental feeding content online.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Responsive Feeding from the modified Child Feeding Questionnaire	Five subscales measuring responsiveness, restriction, use of food as reward, monitoring, and pressure to eat will be assessed using a 5-point Likert scale. Parents will report on these constructs that assess responsive feeding.	Up to 12-month follow up
Providing Structure from the modified Child Feeding Questionnaire	Seven subscales measuring parent decides on portions, family meals, serves measured portions, child helps prepare, eat whenever, indulgent feeding, and eat at regular times will be assessed using a 5-point Likert scale. Parents will report on these constructs that assess responsive feeding.	Up to 12-month follow up
Novel Foods from the modified Child Feeding Questionnaire	Four subscales measuring encouraging exploration, offering new foods, urging new foods, and low pressure strategies for encouragement will be assessed using a 5-point Likert scale. Parents will report on these constructs that assess responsive feeding.	Up to 12-month follow up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Parental Knowledge Questionnaire	A questionnaire measuring aspects of feeding and nutrition knowledge and content covered in the prevention curriculum will be assessed.	Up to 12-month follow up
Child Eating Behaviors	Parental report of child eating behaviors	Up to 12-month follow up

Collaborators and Investigators

• Sponsor: Baylor College of Medicine
• Collaborators: Washington State University; Colorado State University
• Investigators: Principal Investigator: Sheryl O Hughes, PhD, Baylor College of Medicine

Publications and helpful links

General Publications

• Hughes SO, Power TG, Baker SS, Barale KV, Aragon MC, Lanigan JD, Parker L, Silva Garcia K, Auld G, Johnston CA, Micheli N. Short-Term Efficacy of a Childhood Obesity Prevention Program Designed to Pair Feeding Content with Nutrition Education. Child Obes. 2022 Jun 16. doi: 10.1089/chi.2022.0030. Online ahead of print.

Study record dates

Study Major Dates

• Study Start (Actual): September 11, 2017
• Primary Completion (Actual): October 30, 2020
• Study Completion (Actual): October 30, 2020

Study Registration Dates

• First Submitted: May 8, 2017
• First Submitted That Met QC Criteria: May 26, 2017
• First Posted (Actual): May 31, 2017

Study Record Updates

• Last Update Posted (Actual): May 23, 2022
• Last Update Submitted That Met QC Criteria: May 20, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Keywords: family; preschool; eating behaviors
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Pediatric Obesity
• Other Study ID Numbers: H-36455; 2015-68001-23311 (Other Identifier: USDA)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No