Abstract
BackgroundEarly childhood is a critical period for the development of obesity, with new approaches to prevent obesity in this age group needed. We designed and piloted the 3 Pillars Study (3PS), a healthy lifestyle programme informed by attachment theory for parents of preschool-aged children.MethodsA 2-arm, randomised controlled pilot study was conducted to assess the effectiveness of 3PS, a 6-week programme involving a half-day workshop plus 6-week access to a study website. The programme was designed to promote routines around healthy lifestyle behaviours, including sleep, limited screen use, and family meals, within the context of positive, reciprocal parent-child interactions. Parents (n = 54) of children aged 2–4 years who regularly exceeded screen use recommendations (≥1 hour per day), were randomised to the 3PS programme (n = 27) or a wait-list control group (n = 27). Child screen time at 6 weeks was the primary endpoint. Frequency of family meals, parent feeding practices, diet quality, sleep, Child Routine Inventory (to assess predictability of commonly occurring routines), and household chaos were also assessed. Study data were collected online at baseline, 6 weeks, and 12 weeks via REDCap.ResultsNo group differences were observed for changes from baseline in screen time (primary endpoint), feeding behaviour scores, Child Routine Inventory scores, or total night time sleep duration at 6 and 12 weeks, although all measures improved in the hypothesised direction in the 3PS group. Compared with controls, the intervention group demonstrated significant improvements from baseline in household chaos scores (i.e. a reduction in chaos) and a number of measures of sleep outcomes, indicating improved sleep continuity. The programme was highly acceptable to parents.Conclusions and recommendationsA relational approach appears promising as a novel way to promote healthy lifestyle behaviours associated with the prevention of childhood obesity in children aged 2–4 years. A larger study is warranted.
Highlights
Childhood is a critical period for the development of obesity
No group differences were observed for changes from baseline in screen time, feeding behaviour scores, Child Routine Inventory scores, or total night time sleep duration at 6 and 12 weeks, all measures improved in the hypothesised direction in the 3 Pillars Study (3PS) group
A relational approach appears promising as a novel way to promote healthy lifestyle behaviours associated with the prevention of childhood obesity in children aged 2–4 years
Summary
Childhood is a critical period for the development of obesity. Common barriers to operationalising the recommendations provided in obesity prevention programmes have been identified. These include parents’ concerns over how to manage their child’s behaviour (e.g. tantrums over food) [10], lack of time and economic resources [11,12,13], cultural beliefs regarding perceptions of healthy body size [14, 15], parents’ unwillingness to acknowledge and discuss their child’s weight issues [16], and feeling overwhelmed by the chaos and hurriedness of daily life [17]. Childhood is a critical period for the development of obesity, with new approaches to prevent obesity in this age group needed. We designed and piloted the 3 Pillars Study (3PS), a healthy lifestyle programme informed by attachment theory for parents of preschool-aged children.
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