Impact of a Healthy Weight Intervention Embedded Within a National Home Visiting Program on the Home Food Environment

Rachel G Tabak, Alexandra B Morshed, Cynthia D Schwarz, Debra Haire-Joshu, Rachel G Tabak, Alexandra B Morshed, Cynthia D Schwarz, Debra Haire-Joshu

Abstract

Purpose: To determine whether a lifestyle intervention embedded within Parents as Teachers (PAT), a national child development and parenting home visiting program, helped families make food-related home environment changes. Design: Secondary data analysis of a stratified randomized pragmatic trial. (Trial Registration: This study is registered at www.clinicaltrials.gov NCT01567033). Setting: Participant homes in St. Louis, Missouri. Subjects: Women (n = 179 with pre-post data, of 230 with baseline) participating in standard PAT, with overweight or obesity, and at least one preschool child with BMI percentile ≥60%. Intervention: PAT + Healthy Eating and Active Living Taught at Home (HEALTH), embedded elements of the Diabetes Prevention Program within the standard PAT curriculum. PAT + HEALTH addressed specific behaviors that impact caloric intake (e.g., sugar-sweetened beverages), focusing on behavioral and environmental strategies. Consistent with PAT practice, the frequency, number, and focus (i.e., time spent on intervention components) of home visits were determined by the family's needs; dose structure was flexible [on average intervention: 23 (SD = 9), usual care: 13 (SD = 6) visits]. Measures: Food availability/accessibility and distractions in the home were assessed with items drawn largely from the HomeSTEAD Survey. Analysis: Generalized estimating equations (GEEs) were used to test equality of changes between baseline and 24 months in the intervention and usual care groups. Results: The only significant difference in the pattern of change between usual care and intervention was soda availability/accessibility (p = 0.013). Conclusion: This embedded intervention successfully reduced availability/accessibility of sugar-sweetened beverages in the home. However, given the limited impact on other food-related home environment factors, future interventions could seek to more effectively intervene on all aspects of the home environment.

Keywords: eating distractions; food availability; home environment; obesity intervention; research translation.

References

    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA (2014) 311:806–14. 10.1001/jama.2014.732
    1. The GBD 2015 Obesity Collaborators Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. (2017) 377:13–27. 10.1056/NEJMoa1614362
    1. Wang DD, Li Y, Chiuve SE, Hu FB, Willett WC. Improvements in US diet helped reduce disease burden and lower premature deaths, 1999,Äì2012; overall diet remains poor. Health Affairs (2015) 34:1916–22. 10.1377/hlthaff.2015.0640
    1. Baranowski T, Cullen KW, Nicklas T, Thompson D, Baranowski J. Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obes Res. (2003). 11(Suppl.):23S–43. 10.1038/oby.2003.222
    1. Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments: concepts and measures. Am J Health Promot. (2005) 19:330–3, ii. 10.4278/0890-1171-19.5.330
    1. Campbell KJ, Crawford DA, Ball K. Family food environment and dietary behaviors likely to promote fatness in 5-6 year-old children. Int J Obes. (2006) 30:1272–1280. 10.1038/sj.ijo.0803266
    1. Foltz JL, May AL, Belay B, Nihiser AJ, Dooyema CA, Blanck HM. Population-level intervention strategies and examples for obesity prevention in children. Annu Rev Nutr. (2012) 32:391–415. 10.1146/annurev-nutr-071811-150646
    1. Gerards SM, Kremers SP. The role of food parenting skills and the home food environment in children's weight gain and obesity. Curr Obes Rep. (2015) 4:30–6. 10.1007/s13679-015-0139-x
    1. Loth KA, MacLehose RF, Larson N, Berge JM, Neumark-Sztainer D. Food availability, modeling and restriction: how are these different aspects of the family eating environment related to adolescent dietary intake? Appetite (2016) 96:80–6. 10.1016/j.appet.2015.08.026
    1. Ong JX, Ullah S, Magarey A, Miller J, Leslie E. Relationship between the home environment and fruit and vegetable consumption in children aged 6-12 years: a systematic review. Public Health Nutr. (2017) 20:464–80. 10.1017/S1368980016002883
    1. Campbell KJ, Crawford DA, Salmon J, Carver A, Garnett SP, Baur LA. Associations between the home food environment and obesity-promoting eating behaviors in adolescence. Obesity (2007) 15:719–30. 10.1038/oby.2007.553
    1. Verloigne M, Van Lippevelde W, Maes L, Brug J, De Bourdeaudhuij I. Family- and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project. Public Health Nutr. (2012) 15:1380–95. 10.1017/S1368980011003168
    1. Mazarello Paes V, Hesketh K, O'Malley C, Moore H, Summerbell C, Griffin S, et al. Determinants of sugar-sweetened beverage consumption in young children: a systematic review. Obes Rev. (2015) 16:903–13. 10.1111/obr.12310
    1. Gorin AA, Raynor HA, Fava J, Maguire K, Robichaud E, Trautvetter J, et al. . Randomized controlled trial of a comprehensive home environment-focused weight-loss program for adults. Health Psychol. (2013) 32:128–37. 10.1037/a0026959
    1. Kegler MC, Alcantara I, Haardorfer R, Gazmararian JA, Ballard D, Sabbs D. The influence of home food environments on eating behaviors of overweight and obese women. J Nutr Educ Behav. (2014) 46:188–96. 10.1016/j.jneb.2014.01.001
    1. Monteiro CA, Moubarac JC, Levy RB, Canella DS, da Costa Louzada ML, Cannon G. Household availability of ultra-processed foods and obesity in nineteen European countries. Public Health Nutr. (2017) 21:18–26. 10.1017/S1368980017001379
    1. Wansink B, Hanks AS, Kaipainen K. Slim by design: kitchen counter correlates of obesity. Health Educ Behav. (2016) 43:552–58. 10.1177/1090198115610571
    1. Boutelle KN, Birnbaum AS, Lytle LA, Murray DM, Story M. Associations between perceived family meal environment and parent intake of fruit, vegetables, and fat. J Nutr Educ Behav. (2003) 35:24–9. 10.1016/S1499-4046(06)60323-0
    1. Feldman S, Eisenberg ME, Neumark-Sztainer D, Story M. Associations between watching TV during family meals and dietary intake among adolescents. J Nutr Educ Behav. (2007) 39:257–63. 10.1016/j.jneb.2007.04.181
    1. Andaya AA, Arredondo EM, Alcaraz JE, Lindsay SP, Elder JP. 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. 10.1016/j.jneb.2009.11.005
    1. Hartman TJ, Haardorfer R, Whitaker LL, Addison A, Zlotorzynska M, Gazmararian JA, et al. . Dietary and behavioral factors associated with diet quality among low-income overweight and obese African American women. J Am Coll Nutr. (2015) 34:416–424. 10.1080/07315724.2014.982305
    1. Vaughn AE, Ward DS, Fisher JO, Faith MS, Hughes SO, Kremers SP, et al. . Fundamental constructs in food parenting practices: a content map to guide future research. Nutr Rev. (2016) 74:98–117. 10.1093/nutrit/nuv061
    1. Vaughn AE, Dearth-Wesley T, Tabak RG, Bryant M, Ward DS. Development of a comprehensive assessment of food parenting practices: the home self-administered tool for environmental assessment of activity and diet family food practices survey. J Acad Nutr Diet. (2017) 117:214–27. 10.1016/j.jand.2016.07.021
    1. Granner ML, Mburia-Mwalili A. Correlates of television viewing among African American and Caucasian women. Women Health (2010) 50:783–94. 10.1080/03630242.2010.533090
    1. Tumin R, Anderson SE. Television, home-cooked meals, and family meal frequency: associations with adult obesity. J Acad Nutr Diet. (2017) 117:937–45. 10.1016/j.jand.2017.01.009
    1. Emery CF, Olson KL, Lee VS, Habash DL, Nasar JL, Bodine A. Home environment and psychosocial predictors of obesity status among community-residing men and women. Int J Obes. (2015) 39:1401–7. 10.1038/ijo.2015.70
    1. Trofholz AC, Tate AD, Miner MH, Berge JM. Associations between TV viewing at family meals and the emotional atmosphere of the meal, meal healthfulness, child dietary intake, and child weight status. Appetite (2017) 108:361–6. 10.1016/j.appet.2016.10.018
    1. Golan M. Fifteen years of the Family Eating and Activity Habits Questionnaire (FEAHQ): an update and review. Pediatr Obes. (2014) 9:92–101. 10.1111/j.2047-6310.2013.00144.x
    1. Story M, Kaphingst KM, Robinson-O'Brien R, Glanz K. Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health (2008) 29:253–272. 10.1146/annurev.publhealth.29.020907.090926
    1. Ford I, Norrie J. Pragmatic trials. N Engl J Med. (2016) 375:454–463. 10.1056/NEJMra1510059
    1. Parents As Teachers (2016). Annual Report 2015-2016.
    1. Haire-Joshu D, Schwarz CD, Steger-May K, Lapka C, Schechtman K, Brownson RC, et al. . A randomized trial of weight change in a national home visiting program. Am J Prev Med. (2018) 54:341–51. 10.1016/j.amepre.2017.12.012
    1. Parents As Teachers (2015). Annual Report 2014-2015.
    1. Diabetes Prevention Program Research G, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet (2009) 374:1677–86. 10.1016/S0140-6736(09)61457-4
    1. Young MD, Plotnikoff RC, Collins CE, Callister R, Morgan PJ. Social cognitive theory and physical activity: a systematic review and meta-analysis. Obes Rev. (2014) 15:983–995. 10.1111/obr.12225
    1. CDC NHANES (2009). Center for Disease Control and Prevention. National Health and Nutrition Examiniation Survey: Anthropometry Procedures Manual. Available online at: (Accessed June 16, 2017).
    1. Parents as Teachers National Center PAT Quality Assurance Guidelines Available online at: (2016) (Accessed September 26, 2016).
    1. Wen LM, Baur LA, Simpson JM, Xu H, Hayes AJ, Hardy LL, et al. . Sustainability of effects of an early childhood obesity prevention trial over time: a further 3-year follow-up of the healthy beginnings trial. JAMA Pediatr. (2015) 169:543–51. 10.1001/jamapediatrics.2015.0258
    1. Cameron JD, Maras D, Sigal RJ, Kenny GP, Borghese MM, Chaput JP, et al. . The mediating role of energy intake on the relationship between screen time behaviour and body mass index in adolescents with obesity: the HEARTY study. Appetite (2016) 107:437–44. 10.1016/j.appet.2016.08.101
    1. Avery A, Anderson C, McCullough F. Associations between children's diet quality and watching television during meal or snack consumption: a systematic review. Matern Child Nutr. (2017) 13:e12428. 10.1111/mcn.12428
    1. Biddle SJH, Bengoechea Garcia E, Pedisic Z, Bennie J, Vergeer I, Wiesner G. Screen time, other sedentary behaviours, and obesity risk in adults: a review of reviews. Curr Obes Rep. (2017) 6:134–47. 10.1007/s13679-017-0256-9
    1. Haines J, McDonald J, O'Brien A, Sherry B, Bottino CJ, Schmidt ME, et al. . Healthy habits, happy homes: randomized trial to improve household routines for obesity prevention among preschool-aged children. JAMA Pediatr. (2013) 167:1072–9. 10.1001/jamapediatrics.2013.2356
    1. Braude L, Stevenson RJ. Watching television while eating increases energy intake. Examining the mechanisms in female participants. Appetite (2014) 76:9–16. 10.1016/j.appet.2014.01.005
    1. Byrd-Bredbenner C, Martin-Biggers J, Povis GA, Worobey J, Hongu N, Quick V. Promoting healthy home environments and lifestyles in families with preschool children: HomeStyles, a randomized controlled trial. Contemp Clin Trials (2017) 64:139–51. 10.1016/j.cct.2017.10.012
    1. Fulkerson JA, Friend S, Horning M, Flattum C, Draxten M, Neumark-Sztainer D, et al. . Family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus program: a randomized controlled trial. J Acad Nutr Diet. (2017) 118:240–51. 10.1016/j.jand.2017.04.006
    1. Eldridge JD, Devine CM, Wethington E, Aceves L, Phillips-Caesar E, Wansink B, et al. . Environmental influences on small eating behavior change to promote weight loss among Black and Hispanic populations. Appetite (2016) 96:129–37. 10.1016/j.appet.2015.09.011

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться