FirstStep2Health: A cluster randomised trial to promote healthy behaviours and prevent obesity amongst low-income preschoolers

IF 2.7 3区医学 Q1 PEDIATRICS Pediatric Obesity Pub Date : 2024-04-15 DOI:10.1111/ijpo.13122

Jiying Ling, Wachira Suriyawong, Lorraine B. Robbins, Nanhua Zhang, Jean M. Kerver

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Abstract

Objective

To evaluate the preliminary effects of a theory-based, multi-component intervention on improving healthy lifestyle behaviours and preventing obesity amongst low-income preschoolers.

Methods

A cluster randomised controlled trial was conducted at 10 daycare centres. The 16-week FirstStep2Health intervention, grounded in the Actor-Partner Interdependence Model and the Social Cognitive Theory, included five components: a Facebook-based parent programme, three virtual parent meetings, three weekly motivational text messages, parent–child learning via weekly child letters and daycare centre-based child programme.

Results

A total of 95 preschoolers (53 intervention and 42 control) participated. Preschoolers' mean age was 49.27 months, with 57.9% being female, 12.6% being Hispanic and 40% being African American. The intervention significantly decreased intervention preschoolers' fat intake (B = −33.76, p = 0.047) and % body fat (B = −1.18, p = 0.036) compared to the control. During year 2, there were significant intervention effects on increasing skin carotenoids (B = 87.06, p = 0.035). Although not statistically significant, the intervention showed positive effects on increasing preschoolers' fruit/vegetable intake; and decreasing screen time, body mass index z-score and proportion of overweight/obesity.

Conclusions

Even with some potential limitations (small sample size, measurement concerns and confounding with Coronavirus Disease 2019 pandemic), the study's results support the preliminary efficacy of the FirstStep2Health intervention in preventing obesity amongst low-income racially diverse preschoolers.

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FirstStep2Health：促进低收入学龄前儿童健康行为和预防肥胖的分组随机试验

摘要目的评估基于理论的多成分干预措施对改善低收入学龄前儿童的健康生活方式行为和预防肥胖的初步效果。方法在 10 个日托中心进行了分组随机对照试验。为期 16 周的 FirstStep2Health 干预以行动者-伙伴相互依存模型和社会认知理论为基础，包括五个组成部分：基于 Facebook 的家长计划、三次虚拟家长会、每周三次激励短信、通过每周儿童信件进行亲子学习以及基于日托中心的儿童计划。学龄前儿童的平均年龄为 49.27 个月，其中 57.9% 为女性，12.6% 为西班牙裔，40% 为非裔美国人。与对照组相比，干预组学龄前儿童的脂肪摄入量（B=-33.76，p=0.047）和体脂率（B=-1.18，p=0.036）明显减少。在第二年，干预措施对增加皮肤类胡萝卜素有显著效果（B = 87.06，p = 0.035）。结论即使存在一些潜在的局限性（样本量小、测量问题以及与 2019 年冠状病毒疾病大流行的混淆），该研究的结果仍然支持 FirstStep2Health 干预措施在预防低收入种族学龄前儿童肥胖方面的初步效果。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.