Change in Child Physical Activity Following Two Parent-Centered Internet Interventions to Reduce Child Overweight

Abstract

Changing parent behavior without involving the child directly may be an optimal strategy for modifying home environments and, ultimately, child behavior. In addition, Internet programming may be a convenient delivery modality for use with busy families. PURPOSE: to compare two parent-based pilot Internet-delivered weight management interventions on child physical activity. METHODS: Twenty overweight parents (BMI 25 - 50) with at least one child, 8 to 13y, with a BMI ≥ 85th percentile, were recruited and randomized to one of two interventions. Group 1 was general parenting skills applied to the encouragement of healthier nutrition and physical activity behaviors in children (Parenting Skills) and Group 2 was weight loss targeting the overweight parent by focusing on diet and physical activity behaviors (Parent Weight Loss). Each intervention group had a separate website which included 20 weekly lessons, behavioral check-in form, message board, and weekly synchronous chat group led by either a parenting expert (Parenting Skills) or a weight loss counselor (Parent Weight Loss). Physical activity (PA) was assessed in both children and parents by accelerometers worn for 7 days. RESULTS: Children (11 M, 9, F) averaged 10.8 ± 1.6 years and were at the 96th ± 4.4 BMI %ile for age and gender. Both interventions produced a small reduction in percent overweight for age and gender in children. Parents in the Parenting Skills intervention gained 1.2 ± 7.0 lbs, whereas those in the Parent Weight Loss group lost -11.7± 8.0 lbs (t(13)=3.3, p=.006, suggesting that the interventions operated as intended. Controlling for wear time and baseline PA, children in the Parenting group experienced an increase in moderate to vigorous PA (p=.05) compared to children in the Parent Weight Loss Group. Vigorous PA increased as well, but the difference was not significant. Sedentary behavior did not change. Vigorous PA increased for parents in the Weight Loss Group (p<.03), but moderate to vigorous PA did not change. CONCLUSIONS: Results from this pilot study are encouraging, as a first goal for overweight children is to stabilize weight and increase healthy behaviors. Both approaches appear worthy of continued investigation.