Abstract
BackgroundChildhood obesity is a public health issue negatively affecting children’s physical and psychosocial health. Mothers are children’s primary caregivers, thus key players in childhood obesity prevention. Studies have indicated that mothers underestimate their children’s weight. If mothers are unaware of their children’s weight problem, they are less likely to participate in activities preventing and treating excess weight. The “Healthy Change” intervention is designed to change maternal perception of child’s weight (MPCW) through peer-led group health education in childcare settings.Methods/DesignThe “Healthy Change” is a multicenter two-arm randomized trial in four centers. Three centers are in Mexican States (Nuevo Leon, Tamaulipas, and Zacatecas). The fourth center is in San Antonio, Texas, USA. A total of 360 mother-child pairs (90 pairs per center) are to be randomly and evenly allocated to either the intervention or the control group. Intervention group will receive four-session group obesity prevention education. Control group will receive a four-session personal and food hygiene education. The education is delivered by trained peer-mother promotoras. Data will be collected using questionnaires and focus groups. The primary outcome is a change in proportion of mothers with accurate MPCW. Secondary outcomes include change in maternal feeding styles and practices, maternal self-efficacy and actions for managing child excessive weight gain.McNemar’s Test will be used to test the primary outcome. The GLM Univariate procedure will be used to determine intervention effects on secondary outcomes. The models will include the secondary outcome measures as the dependent variables, treatment condition (intervention/control) as the fixed factor, and confounding factors (e.g., mother’s education, children’s gender and age) as covariates. Sub-analyses will be performed to compare intervention effects on primary and secondary outcomes between the samples from Mexico and Texas, USA. Qualitative data will be analyzed through analysis of inductive content. A combined coding model will be developed and used to code transcripts using the NVivo software.DiscussionHealthy Change intervention could help change MPCW, an initial step for obesity prevention among preschoolers. This study presents a first of its kind intervention available in Spanish and English targeting Mexican and Mexican-American mothers in Mexico and USA.Trial registrationISRCTN12281648
Highlights
Childhood obesity is a public health issue negatively affecting children’s physical and psychosocial health
This study presents a first of its kind intervention available in Spanish and English targeting Mexican and Mexican-American mothers in Mexico and United States of America (USA)
It is necessary to implement strategies from childhood to prevent and treat OW-OB paying special attention to parents, given that they act as behavior moderators, and are responsible for the quality and quantity of food made available to their children
Summary
Childhood obesity is a public health issue negatively affecting children’s physical and psychosocial health. Mothers are children’s primary caregivers, key players in childhood obesity prevention. Childhood obesity is a worldwide epidemic that disproportionally affects certain racial/ethnic groups [1]. Mexico is among the countries with the highest prevalence of childhood obesity [2, 3]. It has been documented that overweight (OW) preschoolers were four times more likely to become obese (OB) adolescents than their normal weight counterparts [4]. Given the consequences of overweight and obesity on physical and psychosocial health, as well as the heavy economic burden on health care, Public Health interventions are urgently needed to fight this epidemic in both USA and Mexico [5]
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