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

Colleen Flattum, Michelle Draxten, Melissa Horning, Jayne A Fulkerson, Dianne Neumark-Sztainer, Ann Garwick, Martha Y Kubik, Mary Story, Colleen Flattum, Michelle Draxten, Melissa Horning, Jayne A Fulkerson, Dianne Neumark-Sztainer, Ann Garwick, Martha Y Kubik, Mary Story

Abstract

Background: Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity.

Methods: The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis.

Results: The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities.

Conclusions: Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity.

Trial registration: NCT01538615.

References

    1. U.S. Department of Agriculture and U.S. Department of Health and Human Services . Dietary Guidelines for Americans (7th Edition) Washington DC: US Printing Office; 2010.
    1. Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc. 2010;110:1477–84. doi: 10.1016/j.jada.2010.07.010.
    1. Krebs-Smith SM, Guenther PM, Subar AF, Kirkpatrick SI, Dodd KW. Americans do not meet federal dietary recommendations. J Nutr. 2010;140:1832–8. doi: 10.3945/jn.110.124826.
    1. Fulkerson JA, Kubik MY, Story M, Lytle L, Arcan C. Are there nutritional and other benefits associated with family meals among at-risk youth? J Adolesc Health. 2009;45:389–95. doi: 10.1016/j.jadohealth.2009.02.011.
    1. Fulkerson JA, Neumark-Sztainer D, Hannan PJ, Story M. Family meal frequency and weight status among adolescents: Cross-sectional and 5-year longitudinal associations. Obesity. 2008;16:2529–34. doi: 10.1038/oby.2008.388.
    1. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011;127:1565–74. doi: 10.1542/peds.2010-1440.
    1. Neumark-Sztainer D, Hannan PJ, Story M, Croll J, Perry C. Family meal patterns: Associations with sociodemographic characteristics and improved dietary intake among adolescents. J Am Diet Assoc. 2003;103:317–22. doi: 10.1053/jada.2003.50048.
    1. Leech R, McNaughton S, Crawford D, Campbell K, Pearson N, Timperio A. Family food involvement and frequency of family dinner meals among Australian children aged 10–12 years. Cross-sectional and longitudinal associations with dietary patterns. Appetite. 2014;75:64–70. doi: 10.1016/j.appet.2013.12.021.
    1. Utter J, Scragg R, Schaaf D, Mhurchu CN. Relationships between frequency of family meals, BMI, and nutritional aspects of the home food environment among New Zealand adolescents. Int J Behav Nutr Phys. 2008;5:50. doi: 10.1186/1479-5868-5-50.
    1. Videon TM, Manning CK. Influences on adolescent eating patterns: the importance of family meals. J Adolesc Health. 2003;32:365–73. doi: 10.1016/S1054-139X(02)00711-5.
    1. Andaya A, Arredondo E, Alcaraz J, Lindsay S, Elder J. The association between family meals, TV viewing during meals, and fruit, vegetables, soda, and chips intake among Latino children. J Nutr Educ Behav. 2011;43:308–15.
    1. Welsh E, French S, Wall M. Examining the relationship between family meal frequency and individual dietary intake: does family cohesion play a role? J Nutr Educ Behav. 2011;43:229–35. doi: 10.1016/j.jneb.2010.03.009.
    1. Woodruff S, Kirby A. The associations among family meal frequency, food preparation frequency, self-efficacy for cooking, and food preparation techniques in children and adolescents. J Nutr Educ Behav. 2013;45:296–303. doi: 10.1016/j.jneb.2012.11.006.
    1. Fiese BH, Tomcho TJ, Douglas M, Josephs K, Poltrock S, Baker T. A review of 50 years of research on naturally occuring family routines and rituals. J Fam Psychol. 2002;16:381–90. doi: 10.1037/0893-3200.16.4.381.
    1. Niemeier BS, Hektner JM, Enger KB. Parent participation in weight-related health interventions for children and adolescents: a systematic review and meta-analysis. Prev Med. 2012;55:3–13. doi: 10.1016/j.ypmed.2012.04.021.
    1. Stice E, Shaw H, Marti CN. A meta-analytic review of obesity prevention programs for children and adolescents: the skinny on interventions that work. Psychol Bull. 2006;132:667–91. doi: 10.1037/0033-2909.132.5.667.
    1. Cohen J, Kraak V, Choumenkovitch S, Hyatt R, Economos C. The CHANGE study: a healthy-lifestyles intervention to improve rural children’s diet quality. J Acad Nutr Diet. 2014;114:48–53. doi: 10.1016/j.jand.2013.08.014.
    1. Fulkerson JA, Rydell S, Kubik MY, Lytle L, Boutelle K, Story M, et al. Healthy home offerings via the mealtime environment (HOME): feasibility, acceptability, and outcomes of a pilot study. Obesity. 2010;18(Suppl 1):S69–74. doi: 10.1038/oby.2009.434.
    1. Davis J, Ventura E, Cook L, Gyllenhammer L, Gatto N, LA sprouts A gardening, nutrition, and cooking intervention for Latino youth improves diet and reduces obesity. J Am Diet Assoc. 2011;111:1124–230. doi: 10.1016/j.jada.2011.05.009.
    1. Heim S, Stang J, Ireland M. A garden plot project enhances fruit and vegetable consumption among children. J Am Diet Assoc. 2009;109:1220–6. doi: 10.1016/j.jada.2009.04.009.
    1. Larson NI, Story M, Wall M, Neumark-Sztainer D. Calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns. J Am Diet Assoc. 2006;106:1816–24. doi: 10.1016/j.jada.2006.08.018.
    1. Chu YL, Addo OY, Perry CD, Sudo N, Reicks M. Time spent in home meal preparation affects energy and food group intakes among midlife women. Appetite. 2012;58:438–43. doi: 10.1016/j.appet.2011.12.009.
    1. Woodruff S, Hanning R. A review of family meal influence on adolescents’ dietary intake. Can J Diet Pract Res. 2008;69:14–22. doi: 10.3148/69.1.2008.14.
    1. Durlak J, DuPre E. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41:327–50. doi: 10.1007/s10464-008-9165-0.
    1. Baranowski T, Stables G. Process evaluations of the 5-a-day projects. Health Educ Behav. 2000;27:157–66. doi: 10.1177/109019810002700202.
    1. Fulkerson JA, Neumark-Sztainer D, Story M, Gurvich O, Kubik MY, Garwick A, et al. The healthy home offerings via the mealtime environment (HOME) plus study: design and methods. Contemp Clin Trials. 2014;38(1):59–68. doi: 10.1016/j.cct.2014.01.006.
    1. Baranowski T, Cerin E, Baranowski J. Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials. Int J Behav Nutr Phys Act. 2009;6:6. doi: 10.1186/1479-5868-6-6.
    1. Bandura A. Social foundations of thought and action: a social cognitive theory (1st edition) Englewood Cliffs, NJ: Prentice-Hall; 1986.
    1. Elder J, Lytle L, Sallis J, Rohm Young D, Steckler A, Simons-Morton D, et al. A description of the social-ecological framework used in the trial of activity for adolescent girls (TAAG) Health Educ Res. 2007;2:155–65.
    1. Klein E, Lytle L, Chen V. Social ecological predictors of the transition to overweight in youth: Results from the teens eating for energy and nutrition at schools (TEENS) study. J Am Diet Assoc. 2008;108:1163–9. doi: 10.1016/j.jada.2008.04.007.
    1. Naar-King S, Suarez M. Motivational interviewing with adolescents and young adults (applications of motivational interviewing) New York, USA: The Guilford Press; 2010.
    1. Lundahl B, Burke BL. The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. J Clin Psychol. 2009;65:1232–46. doi: 10.1002/jclp.20638.
    1. Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, et al. Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH behavior change consortium. Health Psychol. 2004;23:443–51. doi: 10.1037/0278-6133.23.5.443.
    1. Eisenberg M, Olson R, Neumark-Sztainer D. Correlations between family meals and psychosocial wellbeing among adolescents. Arch Pediatr Adolesc Med. 2004;158:792–6. doi: 10.1001/archpedi.158.8.792.
    1. Musick K, Meier A. Assessing causality and persistence in associations between family dinners and adolescent well-being. J Marriage Fam. 2012;74:476–93. doi: 10.1111/j.1741-3737.2012.00973.x.
    1. Larson N, Neumark-Sztainer D, Hannan P, Story M. Family meals during adolescence are associated with higher diet quality and healthful meal patterns during youth adulthood. Am Dietetic Assoc. 2007;107:1502–10. doi: 10.1016/j.jada.2007.06.012.
    1. The National Center on Addiction and Substance Abuse at Columbia University . The importance of family dinners VIII. (White Paper) New York, NY: CASA Columbia; 2012.
    1. Davison KK, Birch LL. Childhood overweight: A contextual model and recommendations for future research. Obes Rev. 2001;2:159–71. doi: 10.1046/j.1467-789x.2001.00036.x.
    1. Pratt CA, Stevens J, Daniels S. Childhood obesity prevention and treatment: recommendations for future research. Am J Prev Med. 2008;35:249–52. doi: 10.1016/j.amepre.2008.05.025.
    1. Steele RG, Janicke DM. Changing times call for changing methods: Introduction to the special issue on innovative treatments and prevention programs for pediatric obesity. J Pediatr Psychol. 2013;38:927–31. doi: 10.1093/jpepsy/jst066.
    1. Schwartz RP, Vitolins MZ, Case LD, Armstrong SC, Perrin EM, Cialone J, et al. The YMCA healthy, fit, and strong program: a community-based, family-centered, low-cost obesity prevention/treatment pilot study. Child Obes. 2012;8:577–82.
    1. Gubbels JS, Kremers SPJ, Stafleu A, de Vries SI, Goldbohm RA, Dagnelie PC, et al. Association between parenting practices and children’s dietary intake, activity behavior and development of body mass index: the KOALA birth cohort study. Int J Behav Nutr Phys Act. 2011;8:8–18. doi: 10.1186/1479-5868-8-18.
    1. Waters E, Bj B, Brown T, Kj C, Gao Y, Armstrong R, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011;12

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir