Toddler Obesity Prevention Study (TOPS) increases toddler health‐promoting behaviors

Abstract

ObjectiveTo examine if an 8 session RCT grounded in social cognitive theory (SCT) and focused either on maternal diet and physical activity (PA) or on responsivity and behavior management increases toddler health promoting behaviors.Method274 low‐income mother‐toddlers completed a baseline evaluation: PA (ankle accelerometer worn 7 days, average time/day in moderate/vigorous physical activity), diet (USDA Automated Multi‐Pass Method), video‐taped meal (Emotional Availability Scales), weight & height (converted to age & gender‐specific z‐scores). Randomized to MOM TOPS: maternal diet and PA, TOT TOPS: responsivity and behavior management, or SAFE TOPS: toddler safety (placebo). Follow‐up at 6 months. Intent‐to‐treat longitudinal mixed modeling and generalized estimating equations, adjusted for baseline.ResultsBaseline: 17% toddlers and 51% mothers were obese, 70% Black, 2% Hispanic, & 22% White. At follow‐up, MOM TOPS/TOP TOPS improved over SAFE TOPS in fruit intake (0.49 and 0.93 servings, p=0.014, 0.014) and PA (14.7 and 14.6 minutes, p=0.025, p=0.025. TOT TOPS improved significantly over MOM TOPS in 5 of 6 EAS categories (child involvement & responsively, parent sensitivity, structure, & parent non‐hostility).ConclusionsA brief intervention built on principles of SCT is effective in increasing toddler health‐promoting behaviors of diet, PA, and mealtime responsivity.