Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial
Objectives This study aimed to examine the preliminary efficacy of the FirstStep2Health versus usual care control on improving parents’ lifestyle behaviours (moderate to vigorous physical activity, screen time, fruit/vegetable and fibre intake, skin carotenoids), nutrition and physical activity know...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e081578.full |
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| author | Yan Shi Nanhua Zhang Lorraine B Robbins Jiying Ling Jean M Kerver Tsui-Sui Annie Kao |
| author_facet | Yan Shi Nanhua Zhang Lorraine B Robbins Jiying Ling Jean M Kerver Tsui-Sui Annie Kao |
| author_sort | Yan Shi |
| collection | DOAJ |
| description | Objectives This study aimed to examine the preliminary efficacy of the FirstStep2Health versus usual care control on improving parents’ lifestyle behaviours (moderate to vigorous physical activity, screen time, fruit/vegetable and fibre intake, skin carotenoids), nutrition and physical activity knowledge, self-efficacy, support, parenting style, feeding practices, home environment, anthropometric outcomes (body mass index, % body fat) and blood pressure from baseline to postintervention after adjusting for random cluster effects.Design A cluster randomised controlled trial with 10 Head Start daycare centres (five intervention, five control) was conducted using computer-generated randomisation after baseline data collection.Setting US Head Start daycare centres.Participants 95 parent-child dyads (53 intervention, 42 control).Interventions The 16-week, dyadic, FirstStep2Health intervention included: (1) a daycare-based child programme on healthy mindful eating and physical activity, (2) child letters to parents to connect school learning with home practice, (3) social media-based parent programme to assist parents to promote healthy eating and physical activity at home, (4) virtual group parent meetings via Zoom on topics related to healthy eating and physical activity and (5) weekly motivational messages to increase parental motivation to build a healthy home environment.Results Mixed-effect models were used to examine intervention effects, adjusting for baseline outcome and cluster effects at the daycare and classroom levels. Intervention parents engaged in more moderate to vigorous physical activity (B=0.49, p=0.874) postintervention than controls, although not significantly. However, intervention parents showed significantly higher nutrition knowledge (B=0.87, p=0.009), physical activity knowledge (B=0.95, p=0.049), nutrition self-efficacy (B=0.74, p=0.025) and physical activity self-efficacy (B=0.86, p=0.013) compared with controls at postintervention. Fibre intake was also significantly higher (B=2.99, p=0.049), and intervention parents had lower % body fat (B=−2.56, p=0.005) and systolic blood pressure (B=−10.98, p=0.005) postintervention. No significant effects were found for fruits/vegetables intake, parental support for healthy behaviours, home physical activity environment or authoritative parenting style.Conclusions Future endeavours to proactively engage parents in a dyadic childhood obesity prevention approach such as the FirstStep2Health intervention are warranted to improve outcomes among both children and parents.Trial registration number NCT04164277. |
| format | Article |
| id | doaj-art-877ee9e2e31046c196e82b683e46d1f5 |
| institution | OA Journals |
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| language | English |
| publishDate | 2024-12-01 |
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| series | BMJ Open |
| spelling | doaj-art-877ee9e2e31046c196e82b683e46d1f52025-08-20T01:58:20ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2023-081578Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trialYan Shi0Nanhua Zhang1Lorraine B Robbins2Jiying Ling3Jean M Kerver4Tsui-Sui Annie Kao54 Internet of Things, Wuhan Institute of Technology, Wuhan, China3 Division of Biostatistics and Epidemiology, Cincinnati Children`s Hospital Medical Center, Cincinnati, Ohio, USA1 Michigan State University College of Nursing, East Lansing, Michigan, USA1 Michigan State University College of Nursing, East Lansing, Michigan, USA2 Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA1 Michigan State University College of Nursing, East Lansing, Michigan, USAObjectives This study aimed to examine the preliminary efficacy of the FirstStep2Health versus usual care control on improving parents’ lifestyle behaviours (moderate to vigorous physical activity, screen time, fruit/vegetable and fibre intake, skin carotenoids), nutrition and physical activity knowledge, self-efficacy, support, parenting style, feeding practices, home environment, anthropometric outcomes (body mass index, % body fat) and blood pressure from baseline to postintervention after adjusting for random cluster effects.Design A cluster randomised controlled trial with 10 Head Start daycare centres (five intervention, five control) was conducted using computer-generated randomisation after baseline data collection.Setting US Head Start daycare centres.Participants 95 parent-child dyads (53 intervention, 42 control).Interventions The 16-week, dyadic, FirstStep2Health intervention included: (1) a daycare-based child programme on healthy mindful eating and physical activity, (2) child letters to parents to connect school learning with home practice, (3) social media-based parent programme to assist parents to promote healthy eating and physical activity at home, (4) virtual group parent meetings via Zoom on topics related to healthy eating and physical activity and (5) weekly motivational messages to increase parental motivation to build a healthy home environment.Results Mixed-effect models were used to examine intervention effects, adjusting for baseline outcome and cluster effects at the daycare and classroom levels. Intervention parents engaged in more moderate to vigorous physical activity (B=0.49, p=0.874) postintervention than controls, although not significantly. However, intervention parents showed significantly higher nutrition knowledge (B=0.87, p=0.009), physical activity knowledge (B=0.95, p=0.049), nutrition self-efficacy (B=0.74, p=0.025) and physical activity self-efficacy (B=0.86, p=0.013) compared with controls at postintervention. Fibre intake was also significantly higher (B=2.99, p=0.049), and intervention parents had lower % body fat (B=−2.56, p=0.005) and systolic blood pressure (B=−10.98, p=0.005) postintervention. No significant effects were found for fruits/vegetables intake, parental support for healthy behaviours, home physical activity environment or authoritative parenting style.Conclusions Future endeavours to proactively engage parents in a dyadic childhood obesity prevention approach such as the FirstStep2Health intervention are warranted to improve outcomes among both children and parents.Trial registration number NCT04164277.https://bmjopen.bmj.com/content/14/12/e081578.full |
| spellingShingle | Yan Shi Nanhua Zhang Lorraine B Robbins Jiying Ling Jean M Kerver Tsui-Sui Annie Kao Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial BMJ Open |
| title | Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial |
| title_full | Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial |
| title_fullStr | Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial |
| title_full_unstemmed | Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial |
| title_short | Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial |
| title_sort | effects of the dyadic firststep2health intervention on parents behaviour and anthropometric outcomes a secondary analysis of a cluster randomised trial |
| url | https://bmjopen.bmj.com/content/14/12/e081578.full |
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