Abstract
This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG—compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = −0.05) and BMI-M% (B = −2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.
Highlights
Well-developed literatures document a variety of family and other social influences associated with children’s achieving and maintaining a healthy weight
Recent findings have documented the association between more distal family and peer influences and child healthy weight
The results show the intervention effect over time was moderated by initial BMI%ile group
Summary
Rates of obesity in children remain high [1], and the associated health consequences are a major public health concern [2]. Well-developed literatures document a variety of family and other social influences associated with children’s achieving and maintaining a healthy weight. These include influences proximal to child weight-related behaviors, such as the availability of healthy/unhealthy food options, parent strategies to encourage healthy eating, opportunities and encouragement to engage in physical activities, and parent modeling of healthy behaviors [3]. Recent findings have documented the association between more distal family and peer influences and child healthy weight.
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