Multicomponent Obesity Prevention Intervention in Low-Income Preschoolers: Primary and Subgroup Analyses of the NET-Works Randomized Clinical Trial, 2012-2017

Abstract

Objectives: To evaluate a multicomponent obesity prevention intervention among diverse, low-income preschoolers.

Methods: Parent-child dyads (n = 534) were randomized to the Now Everybody Together for Amazing and Healthful Kids (NET-Works) intervention or usual care in Minneapolis, MN (2012-2017). The intervention consisted of home visits, parenting classes, and telephone check-ins. The primary outcomes were adjusted 24- and 36-month body mass index (BMI).

Results: Compared with usual care, the NET-Works intervention showed no significant difference in BMI change at 24 (-0.12 kg/m2; 95% confidence interval [CI] = -0.44, 0.19) or 36 months (-0.19 kg/m2; 95% CI = -0.64, 0.26). Energy intake was significantly lower in the NET-Works group at 24 (-90 kcal/day; 95% CI = -164, -16) and 36 months (-101 kcal/day; 95% CI = -164, -37). Television viewing was significantly lower in the NET-Works group at 24 (rate ratio = 0.84; 95% CI = 0.75, 0.93) and 36 months (rate ratio = 0.88; 95% CI = 0.78, 0.99). Children with baseline overweight or obesity had lower BMI in the NET-Works group than those in usual care at 36 months (-0.71 kg/m2; 95% CI = -1.30, -0.12). Hispanic children had lower BMI in the NET-Works group than those in usual care at 36 months (-0.59 kg/m2; 95% CI = -1.14, -0.04).

Conclusions: In secondary analyses, NET-Works significantly reduced BMI over 3 years among Hispanic children and children with baseline overweight or obesity.

Trial registration: ClinicalTrials.gov Identifier: NCT01606891.

Figures

FIGURE 1—

CONSORT Diagram for the NET-Works Trial: Minneapolis–St Paul, MN, 2012–2017 Note. Numbers retained at each follow-up include children who had measured body weight and height at that measurement time point. The 24- and 36-month primary outcome analyses were conducted using multiply imputed data sets that included measured data from all randomized children (control group n = 269 and intervention group n = 265) and imputed values for missing body weight and height (analyzed n = 534).

FIGURE 2—

Secondary Analysis of Body Mass Index by Treatment Group and Time by (a) Baseline Body Mass Index and (b) Hispanic Ethnicity: NET-Works Trial, Minneapolis–St Paul, MN, 2012–2017