Nutrition Education for Childhood Obesity
(ONE PATH Trial)
Recruiting in Palo Alto (17 mi)
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Penn State University
Disqualifiers: Child not enrolled, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This proposal uses an innovative methodological framework, the multiphase optimization strategy (MOST), to design an effective and efficient responsive feeding (RF) intervention that promotes child appetite self-regulation among a high-risk sample: families with preschoolers living in rural poverty. The principles of MOST emphasize efficiency, allowing identification of the most efficacious intervention components (i.e., components that contribute to treatment effects) while minimizing participant burden and cost. ONE PATH will intervene on \~768 dyads recruited from 56 classrooms serving largely low-income, rural populations.
Will I have to stop taking my current medications?
The trial information does not specify whether participants need to stop taking their current medications.
What data supports the effectiveness of the treatment 'Nutrition Education for Childhood Obesity'?
Research suggests that responsive feeding, a key component of the treatment, can positively influence parent feeding styles and promote healthier eating behaviors in children, which may help prevent obesity. Studies indicate that interventions focusing on how parents feed their children, rather than just what they feed them, can lead to healthier mealtime interactions and potentially reduce nonresponsive feeding practices.
12345Is the Nutrition Education for Childhood Obesity treatment safe for children?
The available research on responsive feeding interventions, which are part of the Nutrition Education for Childhood Obesity treatment, suggests that these programs are generally safe for children. They focus on promoting healthy eating behaviors and improving parent-child feeding interactions without reported safety concerns.
23678How does the treatment 'Nutrition Education for Childhood Obesity' differ from other treatments for childhood obesity?
This treatment is unique because it focuses on responsive feeding, which emphasizes the interaction between parents and children during feeding times. It aims to teach parents how to recognize and respond to their child's hunger and fullness cues, promoting healthy eating habits from an early age. Unlike other treatments that may focus solely on diet or exercise, this approach integrates parent education and child self-regulation to prevent obesity.
23678Eligibility Criteria
This trial is for families with preschoolers aged 2-6 years, living in rural poverty and enrolled in a participating Head Start center. The parent or caregiver must be over 18 and speak English. Early Childhood Education (ECE) providers are eligible if they work at the participating centers.Inclusion Criteria
I am 18 years or older and the primary caregiver.
Children must be enrolled in a participating Head Start center
I (or my child) can speak English.
+2 more
Exclusion Criteria
Parents will not be eligible to participate if their child is not eligible and/or not enrolled in the study
ECE providers will not be eligible if they do not teach in a participating preschool classroom
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Implementation of responsive feeding and appetite regulation interventions for ECE providers, preschool children, and parents over the school year
9 months
Ongoing engagement through online and in-person activities
Follow-up
Participants are monitored for changes in feeding practices, child appetite regulation, and BMI z-scores
4 weeks
Participant Groups
ONE PATH aims to create an efficient responsive feeding intervention to help children regulate their appetite, potentially reducing childhood obesity. It will test various educational strategies on around 760 families across 64 classrooms using existing nutrition program infrastructure.
8Treatment groups
Experimental Treatment
Active Control
Group I: Parent on/Child onExperimental Treatment2 Interventions
ECE Provider intervention turned off Parent intervention turned on Child intervention turned on
Group II: Parent onExperimental Treatment1 Intervention
ECE Provider intervention turned off Parent intervention turned on Child intervention turned off
Group III: ECE on/Parent onExperimental Treatment2 Interventions
ECE Provider intervention will be turned on Parent intervention will be turned on Child intervention will be turned off
Group IV: ECE on/Child onExperimental Treatment2 Interventions
ECE Provider intervention will be turned on Parent intervention will be turned off Child intervention will be turned on
Group V: ECE onExperimental Treatment1 Intervention
ECE Provider intervention will be turned on Parent intervention will be turned off Child intervention will be turned off
Group VI: Child onExperimental Treatment1 Intervention
ECE Provider intervention turned off Parent intervention turned off Child intervention turned on
Group VII: All Factors OnExperimental Treatment3 Interventions
ECE Provider intervention will be turned on Parent intervention will be turned on Child intervention will be turned on
Group VIII: All Factors OffActive Control1 Intervention
ECE Provider intervention turned off Parent intervention turned off Child intervention turned off
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Pennsylvania State UniversityUniversity Park, PA
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Who Is Running the Clinical Trial?
Penn State UniversityLead Sponsor
References
How pediatricians can improve diet and activity for overweight preschoolers: a qualitative study of parental attitudes. [2022]This study sought feedback from parents of overweight preschoolers on terms for overweight and treatment strategies pediatricians could use to help parents improve diet and activity for their children.
Responsive Feeding: Strategies to Promote Healthy Mealtime Interactions. [2019]Responsive feeding is a derivative of responsive parenting that has been applied to infant and young child feeding. With a theoretical basis in the reciprocal interactions between parents and children, responsive feeding is particularly relevant during complementary feeding as young children progress from an exclusively milk-based liquid diet to the family diet and self-feeding. The period of complementary feeding includes multiple developmental changes that may threaten a successful transition and lead to growth and feeding problems. In spite of high rates of global childhood underweight, stunting, overweight, and obesity, and the inclusion of responsive feeding in the World Health Organization's Global Strategy for Infant and Young Child Feeding, there have been few intervention trials of responsive feeding. The aim of this chapter is to examine how parents and young children navigate the progression in feeding, with an emphasis on complementary feeding, and to address the following topics: (1) navigating the progression of feeding development, (2) provision of responsive feeding, (3) preventing or resolving growth and feeding problems, (4) responsive feeding research, and (5) strategies to promote healthy mealtime interactions. To advance responsive feeding research and practice, clarity is needed in both measurement and intervention strategies, guided by the reciprocity between parent and child interactions inherent in the theoretical basis of responsive feeding.
RAISE (Raising Infants to Be Smart Eaters) Pilot Study. [2023]Background: Many of the complex determinants of obesity originate during infancy when small changes in the environment can permanently influence appetite, behavior, and energy metabolism. Parent feeding style ("how" rather than "what" to feed) has emerged as a potentially important factor in early obesity prevention. Objectives: (1) To assess the feasibility of conducting a brief responsive feeding education intervention by public health nurses during routine well-baby visits. (2) To assess whether this intervention affects parents' attitudes and behavior related to responsive feeding. Methods: Prospective, nonrandomized, comparative pilot study conducted in two communities. Intervention participants were exposed to enhanced responsive feeding education by public health nurses at routine well-baby visits from 0 to 18 months along with wall posters, handouts, automated text messages and tangible takeaways. Parent knowledge and behavior were measured using the Infant Feeding Style Questionnaire and the Toddler Development Index. Feasibility and acceptability were assessed by patients and nurses through open text feedback forms and mid-point and exit interviews. Results: Recruitment (18 intervention; 9 control) and retention fell below targets. Average adherence to protocol by nurses from 0 to 12 months was 89%. Delivery of the intervention was feasible and acceptable, but the additional research-related tasks were challenging in a busy clinical setting. Parents found the different formats and information new and helpful. There was a trend toward less nonresponsive (pressuring, restrictive, laissez-faire) feeding practices in the intervention group. Conclusions: This pilot study demonstrated encouraging results related to overall feasibility and effect on parent feeding style.
Treatment of pediatric obesity. [2007]The primary goal of childhood obesity interventions is regulation of body weight and fat with adequate nutrition for growth and development. Ideally, these interventions are associated with positive changes in the physiologic and psychological sequelae of obesity. To contribute to long-term weight maintenance, interventions should modify eating and exercise behaviors such that new, healthier behaviors develop and replace unhealthy behaviors, thereby allowing healthier behaviors to persist throughout development and into adulthood. This overview of pediatric obesity treatment, using predominantly randomized, controlled studies, highlights important contributions and developments in primarily dietary, activity, and behavior change interventions, and identifies characteristics of successful treatment and maintenance interventions. Potential positive (eg, reduction in blood pressure, serum lipids, and insulin resistance) and negative (eg, development of disordered eating patterns) side effects of treatment also are described. Recommendations for improving implementation of childhood obesity treatments, including application of behavioral choice theory, improving knowledge of response extinction and recovery in regards to behavior relapse, individualization of treatment, and integration of basic science with clinical outcome research, are discussed.
Responsive feeding is embedded in a theoretical framework of responsive parenting. [2023]Children throughout the world are confronted with growth problems ranging from underweight and stunting to overweight and obesity. The development of healthy eating behaviors depends on both healthy food and responsive parenting behaviors. With origins from anthropology, psychology, and nutrition, responsive parenting reflects reciprocity between child and caregiver, conceptualized as a 4-step mutually responsive process: 1) the caregiver creates a routine, structure, expectations, and emotional context that promote interaction; 2) the child responds and signals to the caregiver; 3) the caregiver responds promptly in a manner that is emotionally supportive, contingent, and developmentally appropriate; and 4) the child experiences predictable responses. This paper examines evidence for the practice and developmental benefits of responsive parenting with a view to providing a theoretical basis for responsive feeding. Recommendations are made that future efforts to promote healthy growth and to prevent underweight and overweight among young children incorporate and evaluate responsive feeding.
[How to feed children? Healthy eating behaviors starting at childhood]. [2021]Interventions to prevent malnutrition or overweight in children focus on the diet, and give little attention to the behaviors of their caretakers. In their first two years of life, children adopt practices that are embedded in their environment and the behaviors of their caretakers, thus turning into nutrition patterns that will persist during their lifetimes. Therefore, children and caretakers establish a relationship in which they recognize, construe and respond to verbal and non verbal communication signs. Feeding a child by adopting a "responsive" behavior in which caretakers provide guidance and structure, and respond to children's signs of hunger and satiety promotes self-regulation and children's awareness of healthy nutrition. In this article, we give recommendations to include responsive nutrition and model healthy eating behaviors in nutritional interventions.
INSIGHT responsive parenting intervention and infant feeding practices: randomized clinical trial. [2019]What, when, how, how much, and how often infants are fed have been associated with childhood obesity risk. The objective of this secondary analysis was to examine the effect of a responsive parenting (RP) intervention designed for obesity prevention on parents' infant feeding practices in the first year after birth.
Responsive feeding: implications for policy and program implementation. [2023]In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation.