Parent Involvement in Diet or Physical Activity Interventions to Treat or Prevent Childhood Obesity: An Umbrella Review

Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research

The hot project (healthy outcome for teens): an innovative online intervention for prevention and treatment of obesity and type 2 diabetes

ABSTRACT The rate of childhood obesity has more than tripled in the past 30 years from 5% to 18%. The risk of developing Type 2 diabetes increases in a dose-dependent manner with the increase in body mass index. Overweight and obesity are caused by caloric imbalance. Thus, healthy lifestyle habits, including healthy eating and physical activity, are recommended for the prevention and management of obesity and Type 2 diabetes. The HOT (Healthy Outcome for Teens) Project is an innovative online intervention for adolescents for the prevention and treatment of obesity and Type 2 diabetes by focusing on healthy eating and physical activity. The primary purpose of the HOT Project was to determine if web-based modules would increase awareness about obesity and diabetes prevention, behavior, and psychosocial variables, through active online learning (AOL) versus passive online learning (POL) with the same content framed within a behavioral theory. The HOT project was a six-phase intervention. First, the website was adapted from an adult website to use with the middle school students by recruiting a teen council for their opinions. Second, the intervention, framed within Social Cognitive Theory (SCT), was implemented in three schools in east central Illinois. Third, focus groups were conducted with the participants of the SCT intervention to assess their acceptability of the intervention. Fourth, the website was adjusted based on the results of the two studies. Fifth, the intervention was again implemented in two schools and this time framed within the Theory of Planned Behavior (TPB). Sixth, focus groups were conducted to explore the observational findings of the TPB intervention. The participants improved knowledge from both the SCT and TPB interventions but for the SCT subjects, active online learners showed significantly more improvement than the passive online learners. The subjects in the SCT trial showed some improvement for outcome expectations but not for self-efficacy. However, the subjects in the TPB trial, showed improvement for all constructs of theory implemented in the study. The results suggest that an interactive web-based intervention is a suitable target for reaching middle school students for addressing health problems. Moreover, TPB is more appropriate for this population for short-term interventions

Using Process Evaluation Results to Compare Peer and Adult Leader Delivery of the PAWS (Peer-Education about Weight Steadiness) Club Program

To date, there is limited published literature on process evaluation of adolescent health promotion programs. In this paper, we describe the methods and results of PAWS Club process evaluation over 2 years of implementation to compare the effectiveness of delivery by peer and adult leaders. PAWS (Peer-education About Weight Steadiness) Club was a 12-week healthy lifestyle program, delivered to 6th and 7th graders by peer and adult educators, using cluster randomized controlled design. Peer educators were 8th graders in the program schools and adult educators were staff/teachers in the program schools. Trained university students filled out fidelity logs at each session led by peer and adult educators to assess program delivery. The fidelity logs included questions to collect information about the number of participants, duration of the session, percent of activities completed, and if lessons started on time, lesson objectives were clearly stated, lesson objectives were emphasized, demonstrations were visible to participants, all activities were completed, the leader was familiar with lessons, the leader maintained an appropriate pace, the leader kept participants on track, and the leader asked if participants had any questions. Adult educators had a higher mean performance for all questions compared to peer leaders. Significant differences were observed for emphasizing lesson objectives (p = 0.005), making demonstrations visible to participants (p = 0.031), being familiar with the lesson plan (p = 0.000), maintaining an appropriate pace (p = 0.000), keeping participants on track (p = 0.000), and asking if participants had any questions (p = 0.000). Significance was set at p < 0.05. Findings from the current study have implications for designing and conducting a process evaluation of complex healthy lifestyle programs with adolescents in schools. Additional training of peer educators may be needed to enhance program delivery