A randomised controlled trial and mediation analysis of the ‘Healthy Habits’, telephone-based dietary intervention for preschool children

Amanda Fletcher,Rebecca Wyse,Patrick Mcelduff,Jenny Bowman,Sarah Duncan,Luke Wolfenden

doi:10.1186/1479-5868-10-43

Abstract

BackgroundConsumption of non-core foods in childhood is associated with excessive weight gain in childhood. Parents play a vital role in establishing healthy diet behaviours in young children. The aim of this study was to assess the effectiveness of a telephone-based intervention in reducing child consumption of non-core foods, and to examine parent and home food environment mediators of change in child consumption.MethodsThe ‘Healthy Habits’ trial utilised a clustered randomised controlled design.Setting/participantsParents were recruited from 30 preschools (N = 394 participants, mean age 35.2±5.6 years). Parents randomized to the intervention group received four telephone contacts and print materials. Parents allocated to the control condition receive generic print materials only. Non-core food consumption was assessed using a validated child dietary questionnaire at baseline, 2 and 6 months post recruitment in 2010.ResultsThe intervention was effective in reducing child consumption of non-core foods at 2 months (intention to treat analysis: z=-2.83, p<.01), however this effect was not maintained at 6 months. Structural equation modelling using 2 month data indicated that child access to non-core foods in the home and child feeding strategies mediated the effect of the intervention.ConclusionThe telephone-based intervention shows promise in improving short term dietary behaviour in preschool age children, however further development is needed to sustain the effect in the long-term.Trial registrationAustralian Clinical Trials Registry: ACTRN12609000820202

Highlights

Consumption of non-core foods in childhood is associated with excessive weight gain in childhood
The intervention was effective in reducing child consumption of non-core foods at 2 months, this effect was not maintained at 6 months
Structural equation modelling using 2 month data indicated that child access to non-core foods in the home and child feeding strategies mediated the effect of the intervention

Summary

Introduction

Consumption of non-core foods in childhood is associated with excessive weight gain in childhood. Parents play a vital role in establishing healthy diet behaviours in young children. Parents randomized to the intervention group received four telephone contacts and print materials. Parents allocated to the control condition receive generic print materials only. The positive association between excessive consumption of non-core foods and obesity in children and adults is well established [7]. Interventions targeting reductions in the intake of non-core foods have been found to be effective in preventing excessive weight gain in children [8]. Recommendations for the prevention of overweight and obesity encourage diets consistent with healthy eating guidelines which state that children only consume non-core foods occasionally, and in small amounts [9]

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