NOURISH-T: Targeting caregivers to improve health behaviors in pediatric cancer survivors with obesity

Abstract

Background: Obesity rates in pediatric cancer survivors (PCS) are alarmingly high. Although healthy lifestyle changes may prevent future health complications, promoting healthy behaviors in PCS is challenging, and few interventions have successfully addressed this issue.

Procedure: This randomized control trial evaluated the feasibility and preliminary effectiveness of a parent-focused six-session intervention, NOURISH-T (Nourishing Our Understanding of Role Modeling to Improve Support and Health for Healthy Transitions), compared with enhanced usual care (EUC) on the outcomes of caregiver and PCS anthropometric measurements, eating behaviors, and physical activity. Behavioral and self-report assessments of caregivers and PCS in both conditions were conducted at baseline, postintervention, and at a 4-month follow-up.

Results: In comparison to no change among EUC caregivers, NOURISH-T caregivers showed small yet significant decreases from baseline through follow-up on BMI, waist-hip ratio, and total daily caloric intake. However, there was no change with regard to daily fat and sugar intake. NOURISH-T caregivers also showed positive changes in their child feeding behaviors, including decreases in pressuring their child to eat and restricting their child's eating and increased eating together as a family. Similarly, decreases in BMI percentile, waist-hip ratio, and sugary beverage consumption were found for NOURISH-T PCS from baseline to postintervention. NOURISH-T PCS also significantly increased their daily steps, whereas EUC PCS decreased their daily steps.

Conclusions: Results suggest that an intervention targeting parents is feasible and demonstrates preliminary effectiveness. NOURISH-T showed a longer term effect on caregivers, and, although shorter term effect, a positive impact on the PCS themselves. Implications for ways to improve NOURISH-T as an intervention for increasing healthy behaviors of PCS are discussed.

Trial registration: ClinicalTrials.gov NCT02815982.

Keywords: parent training; pediatric cancer; pediatric obesity; randomized clinical.

Conflict of interest statement

AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS

The author(s) indicated no potential conflicts of interest.

© 2018 Wiley Periodicals, Inc.

Figures

Figure 1

Caregiver Anthropometric Outcomes from Baseline to Follow-Up

Figure 2

Family Eating Patterns from Baseline to Follow-Up

Figure 3

PCS Anthropometric Outcomes from Baseline to Post-Intervention

Figure 4

PCS Daily Steps Averaged Over a Week from Baseline to Post-Intervention