2 research outputs found
A weight management programme for fathers of children aged 4–11 years: cultural adaptation and the Healthy Dads, Healthy Kids UK feasibility RCT
Background: More men than women in the UK are living with overweight or obesity, but men are less
likely to engage with weight loss programmes. Healthy Dads, Healthy Kids is an effective Australian
weight management programme that targets fathers, who participate with their primary school-aged
children. Behavioural interventions do not always transfer between contexts, so an adaptation of the
Healthy Dads, Healthy Kids programme to an ethnically diverse UK setting was trialled.
Objectives: To adapt and test the Australian Healthy Dads, Healthy Kids programme for delivery to
men in an ethnically diverse, socioeconomically disadvantaged UK setting.
Design: Phase 1a studied the cultural adaptation of the Healthy Dads, Healthy Kids programme and
was informed by qualitative data from fathers and other family members, and a theoretical framework.
Phase 1b was an uncontrolled feasibility trial. Phase 2 was a randomised controlled feasibility trial.
Setting: Two ethnically diverse, socioeconomically disadvantaged UK cities.
Participants: In phase 1a, participants were parents and family members from black and minority
ethnic groups and/or socioeconomically deprived localities. In phases 1b and 2, participants were
fathers with overweight or obesity and their children aged 4–11 years. Interventions: The adapted Healthy Dads, Healthy Kids intervention comprised nine sessions that
targeted diet and physical activity and incorporated joint father–child physical activity. Healthy Dads,
Healthy Kids was delivered in two programmes in phase 1b and four programmes in phase 2. Those in
the comparator arm in phase 2 received a family voucher to attend a local sports centre.
Main outcome measures: The following outcomes were measured: recruitment to the trial, retention,
intervention fidelity, attendance, feasibility of trial processes and collection of outcome data.
Results: Forty-three fathers participated (intervention group, n = 29) in phase 2 (48% of recruitment
target), despite multiple recruitment locations. Fathers’ mean body mass index was 30.2 kg/m2 (standard
deviation 5.1 kg/m2); 60.2% were from a minority ethnic group, with a high proportion from disadvantaged
localities. Twenty-seven (63%) fathers completed follow-up at 3 months. Identifying sites for delivery at a
time that was convenient for the families, with appropriately skilled programme facilitators, proved
challenging. Four programmes were delivered in leisure centres and community venues. Of the participants
who attended the intervention at least once (n = 20), 75% completed the programme (attended five or
more sessions). Feedback from participants rated the sessions as ‘good’ or ‘very good’ and participants
reported behavioural change. Researcher observations of intervention delivery showed that the sessions
were delivered with high fidelity.
Conclusions: The intervention was well delivered and received, but there were significant challenges in
recruiting overweight men, and follow-up rates at 3 and 6 months were low. We do not recommend
progression to a definitive trial as it was not feasible to deliver the Healthy Dads, Healthy Kids programme
to fathers living with overweight and obesity in ethnically diverse, socioeconomically deprived communities
in the UK. More work is needed to explore the optimal ways to engage fathers from ethnically diverse
socioeconomically deprived populations in research
An exploration of the longitudinal relation between parental feeding practices and child anthropometric adiposity measures from the West Midlands Active Lifestyle and Healthy Eating in Schoolchildren (WAVES) Study
Background: Some research suggests that parent or carer feeding practices may influence children's weight patterns, but longitudinal evidence is limited and inconsistent. Objective: The aim of this study was to investigate the relation between various parent or carer feeding practices when a child is aged 7-8 y and proxy measurements of child adiposity at age 8-9 y (weight status, waist-to-height ratio, and body fat percentage). Design: The study was a secondary analysis of data from the West Midlands Active Lifestyle and Healthy Eating in Schoolchildren (WAVES) Study comprising a diverse sample of parents and carers and their children from 54 primary schools in the West Midlands, England [n = 774 parent-child dyads (53% of the WAVES study sample)]. Information on feeding practices was collected with the use of subscales from the Comprehensive Feeding Practices Questionnaire, completed by the child's main parent or carer (self-defined). Child height, weight, bioelectrical impedance, and waist circumference were measured and converted into 3 proxy measurements of adiposity (weight status, waist-to-height ratio, and body fat percentage). Associations between these measurements and parent or carer feeding practices were examined with the use of mixed-effects logistic regression models. Results: Of the questionnaire respondents, 80% were mothers, 16% were fathers, and 4% were other carers. Median standardized subscale scores ranged from 1.7 (emotion regulation: IQR = 1.0) to 4.0 (monitoring and modeling: IQR = 1.5), and significantly different subscale scores were present between child weight statuses for emotion regulation, pressure to eat, and restriction for weight control. Logistic regression modeling showed that when baseline adiposity measures were included as covariates, all associations between parental feeding practices at age 7-8 y and measures of adiposity at age 8-9 y were attenuated. Conclusions: Observed relations between various parental feeding practices and later adiposity are mitigated by inclusion of the baseline adiposity measure. This finding lends support to the theory of reverse causation, whereby the child's size may influence parental choice of specific feeding practices rather than the child's subsequent weight status being a consequence of these feeding practices