Abstract
BackgroundChildhood obesity is a public health crisis, particularly in low-income, minority populations in the United States. Innovative and technology-enhanced interventions may be an engaging approach to reach at-risk youth and their parents to improve dietary behaviors and feeding practices. However, such tools are limited, especially ones that are theory-based; co-developed with user-centered approaches; tailored to low-income, minority preadolescents; and include parent-focused content.ObjectiveThe objectives of this study include assessing the feasibility and acceptability and exploring the potential impact of the Intervention INC (Interactive Nutrition Comics for urban, minority preadolescents) Web-based tool, which is focused on decreasing childhood obesity risk in black/African American and Latino children aged 9 to 12 years.MethodsIntervention INC is underpinned by the narrative transportation theory, social cognitive theory, and health belief model, and it was co-developed by children and parents from the intended population. The child component consists of a 6-chapter interactive nutrition comic optimized for use on tablet devices, a goal-setting and self-assessment feature, and weekly text/email messages and reminders. The parental component consists of 6 Web-based newsletters, access to the child comic, and weekly text/email messages and reminders. The tool was evaluated using a pilot, single-blind, 2-group randomized controlled study design. Child-parent dyads were randomized to either the experimental or comparison group and assigned to a targeted behavior (increase fruit/vegetable or water intake) based on initial screening questions. Data were collected at 4 time points: baseline (T1), intervention midpoint (T2), intervention endpoint (T3), and 3 months postintervention (T4). Primary measures comprise usage, usability, and feasibility of the Web-based tool. Secondary measures comprise dietary knowledge, preferences, and intake and anthropometric measures (for child) and feeding practices and home food environment (for parent).ResultsStudy enrollment was completed in November 2017. A total of 89 child-parent dyads were randomized to either the experimental (n=44) or comparison (n=45) group. Data analysis is currently being conducted.ConclusionsThis study aims to implement and assess an innovative approach to deliver health messages and resources to at-risk minority preadolescents and their parents. If found to be acceptable, engaging, feasible, and a potential approach to improve dietary behaviors, a full-fledged randomized controlled trial will be conducted to assess its efficacy and potential impact.Trial RegistrationClinicalTrials.gov NCT03165474; https://clinicaltrials.gov/ct2/show/NCT03165474 (Archived by WebCite at http://www.webcitation.org/73122IjgP)International Registered Report Identifier (IRRID)RR1-10.2196/10682
Highlights
Childhood obesity continues to be a serious clinical and public health issue in the United States
The purpose of this paper is to describe the protocol for the implementation and assessment of the Intervention INC (Interactive Nutrition Comics for urban, minority preadolescents) Web-based tool, which focuses on decreasing childhood obesity risk in Latino and black/African American children aged 9 to 12 years
As usage data are key to understanding technology-based behavioral intervention dose and how participants engage with the Web-based tool itself [81], patterns of usage by children and parents/guardians will be described/calculated in multiple ways including as a binary variable by week, as an ordered variable based on usage over 6 weeks, or as a continuous variable measured as number of times visited over 6 weeks
Summary
Childhood obesity continues to be a serious clinical and public health issue in the United States. Effective yet innovative interventions are needed to capture the attention of children living in a multimedia environment Visual narratives such as comics may engage today’s youth population around health topics and promote positive psychosocial and behavioral outcomes [7,8,9]. Childhood obesity is a public health crisis, in low-income, minority populations in the United States. Innovative and technology-enhanced interventions may be an engaging approach to reach at-risk youth and their parents to improve dietary behaviors and feeding practices. Such tools are limited, especially ones that are theory-based; co-developed with user-centered approaches; tailored to low-income, minority preadolescents; and include parent-focused content
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