Abstract
BackgroundEarly childhood is a critical window for preventing obesity and chronic disease. Yet, 1 in 4 Australian children aged 5 years and under are affected by overweight or obesity; and significant proportions of children under 5 years fail to meet guidelines for diet quality, physical activity (PA), screen time, and sleep. Consequently, effective interventions to promote healthy lifestyle behaviors and prevent obesity during early childhood are needed. Community playgroups provide an opportunity for parents, carers, and children to meet in a safe and relaxed environment to play and share information. The structure, low cost and reach of playgroups provide a unique platform to engage parents in a scalable program to promote healthful lifestyle behaviors and prevent childhood obesity. However, the evidence base for the effectiveness of health promotion programs delivered in community playgroup settings is limited and lacking credible evidence from rigorously conducted randomized controlled trials.MethodsThe Healthy Conversations @ Playgroup randomized controlled trial (RCT) aims to address the underlying behavioral risk factors for obesity by helping parents take effective steps to improve their child’s dietary, PA, screen time, and sleep behaviors. The intervention program comprises 10 “healthy conversations” led by a trained peer facilitator, designed to increase parents’ behavioral capability and self-efficacy to implement autonomy-supportive parenting practices. The program will be delivered biweekly during regularly scheduled playgroup sessions over 10-weeks. Effectiveness will be tested in a 2-arm cluster RCT involving 60 community playgroups in three states across Australia. After baseline assessments, participating playgroups will be randomly allocated to either intervention or wait-list control conditions. Primary outcomes (vegetable intake, discretionary foods, daily PA, screen time, sleep duration, and body mass index [BMI] z-score) will be assessed at baseline, immediately post-intervention (10-weeks; T2) and 6-months post-intervention (T3). Outcomes will be assessed for differential change at T2 and T3.DiscussionThe Healthy Conversations @ Playgroup trial will rigorously evaluate a novel peer-led intervention program to promote healthful lifestyle behaviors and prevent obesity in children and families attending community playgroups. If effective, the program could be immediately scaled-up and delivered in community playgroups across Australia.Trial registrationTrial registered 22nd January 2021 with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000055808).
Highlights
Childhood is a critical window for preventing obesity and chronic disease
Up to 40% of Australian parents report that their infants and young children experience sleep problems and between and 20% of preschool children do not meet current sleep guidelines of to 14 h per 24-h period [10]
Eligibility criteria Playgroups meeting the following inclusion criteria will be eligible to participate in the program: located within a 150 km radius of the Queensland Centre for Children’s Health Research, Flinders University, South Australia or Telethon Kids Institute, University of Western Australia; operating as a community playgroup; and at least four parent-child dyads willing to participate in the evaluation of the program
Summary
Secondary outcomes: parental self-efficacy, parenting practices related to healthy eating, physical activity, screen time, and sleep 1 Provided only to parents allocated to the intervention group disease, congenital heart disease), will be able to participate in the program, but will be excluded from the evaluation. The standard deviation for change in BMI z-score was based on data from the NOURISH randomized controlled trial [20] Based on these calculations, a sample of 30 playgroups per condition achieves ≥80% power to detect the hypothesized between-group differences for each of the primary outcomes. Grounded in Social Cognitive Theory [23] and Self-Determination Theory [24], the intervention comprises 10 “healthy conversations”, led by a peer facilitator, designed to increase parents’ behavioral capability and self-efficacy to implement autonomy-supportive parenting practices related to healthy eating, physical activity, screen time, and sleep. Condition, time, the condition by time interaction will be included as fixed effects, with playgroup nested within condition, parentchild dyads nested within playgroup and condition, and the playgroup by time interaction nested within condition included as random effects
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