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Healthy Habits, Happy Homes

Healthy Habits, Happy Homes ImportanceRacial/ethnic and socioeconomic disparities exist across risk factors for childhood obesity. ObjectiveTo examine the effectiveness of a home-based intervention to improve household routines known to be associated with childhood obesity among a sample of low-income, racial/ethnic minority families with young children. DesignRandomized trial. SettingThe intervention was delivered in the families’ homes. ParticipantsThe study involved 121 families with children aged 2 to 5 years who had a television (TV) in the room where he or she slept; 111 (92%) had 6-month outcome data (55 intervention and 56 control). The mean (SD) age of the children was 4.0 (1.1) years; 45% were overweight/obese. Fifty-two percent of the children were Hispanic, 34% were black, and 14% were white/other. Nearly 60% of the families had household incomes of $20 000 or less. InterventionsThe 6-month intervention promoted 4 household routines, family meals, adequate sleep, limiting TV time, and removing the TV from the child’s bedroom, using (1) motivational coaching at home and by phone, (2) mailed educational materials, and (3) text messages. Control subjects were mailed materials focused on child development. Main Outcomes and MeasuresChange in parent report of frequency of family meals (times/wk), child sleep duration (hours/d), child weekday and weekend day TV viewing (hours/d), and the presence of a TV in the room where the child slept from baseline to 6 months. A secondary outcome was change in age- and sex-adjusted body mass index (calculated as weight in kilograms divided by height in meters squared). ResultsCompared with control subjects, intervention participants had increased sleep duration (0.75 hours/d; 95% CI, 0.06 to 1.44; P = .03), greater decreases in TV viewing on weekend days (−1.06 hours/d; 95% CI, −1.97 to −0.15; P = .02), and decreased body mass index (−0.40; 95% CI, −0.79 to 0.00; P = .05). No significant intervention effect was found for the presence of a TV in the room where the child slept or family meal frequency. Conclusions and RelevanceOur results suggest that promoting household routines, particularly increasing sleep duration and reducing TV viewing, may be an effective approach to reduce body mass index among low-income, racial/ethnic minority children. Longer-term studies are needed to determine maintenance of behavior change. Trial Registrationclinicaltrials.gov Identifier: NCT01565161 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Pediatrics American Medical Association

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Publisher
American Medical Association
Copyright
Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6203
eISSN
2168-6211
DOI
10.1001/jamapediatrics.2013.2356
pmid
24019074
Publisher site
See Article on Publisher Site

Abstract

ImportanceRacial/ethnic and socioeconomic disparities exist across risk factors for childhood obesity. ObjectiveTo examine the effectiveness of a home-based intervention to improve household routines known to be associated with childhood obesity among a sample of low-income, racial/ethnic minority families with young children. DesignRandomized trial. SettingThe intervention was delivered in the families’ homes. ParticipantsThe study involved 121 families with children aged 2 to 5 years who had a television (TV) in the room where he or she slept; 111 (92%) had 6-month outcome data (55 intervention and 56 control). The mean (SD) age of the children was 4.0 (1.1) years; 45% were overweight/obese. Fifty-two percent of the children were Hispanic, 34% were black, and 14% were white/other. Nearly 60% of the families had household incomes of $20 000 or less. InterventionsThe 6-month intervention promoted 4 household routines, family meals, adequate sleep, limiting TV time, and removing the TV from the child’s bedroom, using (1) motivational coaching at home and by phone, (2) mailed educational materials, and (3) text messages. Control subjects were mailed materials focused on child development. Main Outcomes and MeasuresChange in parent report of frequency of family meals (times/wk), child sleep duration (hours/d), child weekday and weekend day TV viewing (hours/d), and the presence of a TV in the room where the child slept from baseline to 6 months. A secondary outcome was change in age- and sex-adjusted body mass index (calculated as weight in kilograms divided by height in meters squared). ResultsCompared with control subjects, intervention participants had increased sleep duration (0.75 hours/d; 95% CI, 0.06 to 1.44; P = .03), greater decreases in TV viewing on weekend days (−1.06 hours/d; 95% CI, −1.97 to −0.15; P = .02), and decreased body mass index (−0.40; 95% CI, −0.79 to 0.00; P = .05). No significant intervention effect was found for the presence of a TV in the room where the child slept or family meal frequency. Conclusions and RelevanceOur results suggest that promoting household routines, particularly increasing sleep duration and reducing TV viewing, may be an effective approach to reduce body mass index among low-income, racial/ethnic minority children. Longer-term studies are needed to determine maintenance of behavior change. Trial Registrationclinicaltrials.gov Identifier: NCT01565161

Journal

JAMA PediatricsAmerican Medical Association

Published: Nov 1, 2013

References