Julie C Lumeng1,2,3, Alison L Miller4,5, Mildred A Horodynski6, Holly E Brophy-Herb7, Dawn Contreras7,8, Hannah Lee4, Julie Sturza4, Niko Kaciroti4,9, Karen E Peterson4,3,10. 1. Center for Human Growth and Development and jlumeng@umich.edu. 2. Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan. 3. Nutritional Sciences, and. 4. Center for Human Growth and Development and. 5. Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan. 6. College of Nursing and. 7. Department of Human Development and Family Studies, Michigan State University, Lansing, Michigan. 8. Health and Nutrition Institute, Michigan State University Extension, Lansing, Michigan; and. 9. Departments of Biostatistics. 10. Department of Nutrition, Harvard W.T. Chan School of Public Health, Boston, Massachusetts.
Abstract
OBJECTIVES: To determine the effect of an intervention to improve emotional and behavioral self-regulation in combination with an obesity-prevention program on the prevalence of obesity and obesity-related behaviors in preschoolers. METHODS: This was a cluster-randomized intervention trial in Head Start (HS) classrooms conducted in each of 4 academic years from 2011 to 2015. Participants (697 children; 49% boys; mean age: 4.1 ± 0.5 years; 48% white, 30% African American, 12% Hispanic) were randomly assigned by classroom to 1 of 3 intervention arms: (1) HS + Preschool Obesity Prevention Series (POPS) + Incredible Years Series (IYS) (HS enhanced by the POPS [program targeting evidence-based obesity-prevention behaviors] and the IYS [program to improve children's self-regulation]), (2) HS+POPS, or (3) HS. Primary outcomes were changes in prevalence of obesity, overweight/obesity, BMI z score, and teacher-reported child emotional and behavioral self-regulation; secondary outcomes were dietary intake, outdoor play, screen time, and parent nutrition knowledge and nutrition self-efficacy. RESULTS:HS+POPS+IYS improved teacher-reported self-regulation compared with HS+POPS (P < .001) and HS (P < .001), but there was no effect on the prevalence of obesity (16.4% preintervention to 14.3% postintervention in HS+POPS+IYS versus 17.3% to 14.4% in HS+POPS [P = .54] versus 12.2% to 13.0% in HS [P = .33]). There was no effect of HS+POPS compared with HS alone (P = .16). There was no effect on other outcomes except for sugar-sweetened beverage intake (HS+POPS+IYS resulted in a greater decline than HS; P = .005). CONCLUSIONS: An intervention for parents and children to improve HS preschoolers' emotional and behavioral self-regulation in combination with an obesity-prevention curriculum did not reduce obesity prevalence or most obesity-related behaviors.
RCT Entities:
OBJECTIVES: To determine the effect of an intervention to improve emotional and behavioral self-regulation in combination with an obesity-prevention program on the prevalence of obesity and obesity-related behaviors in preschoolers. METHODS: This was a cluster-randomized intervention trial in Head Start (HS) classrooms conducted in each of 4 academic years from 2011 to 2015. Participants (697 children; 49% boys; mean age: 4.1 ± 0.5 years; 48% white, 30% African American, 12% Hispanic) were randomly assigned by classroom to 1 of 3 intervention arms: (1) HS + Preschool Obesity Prevention Series (POPS) + Incredible Years Series (IYS) (HS enhanced by the POPS [program targeting evidence-based obesity-prevention behaviors] and the IYS [program to improve children's self-regulation]), (2) HS+POPS, or (3) HS. Primary outcomes were changes in prevalence of obesity, overweight/obesity, BMI z score, and teacher-reported child emotional and behavioral self-regulation; secondary outcomes were dietary intake, outdoor play, screen time, and parent nutrition knowledge and nutrition self-efficacy. RESULTS:HS+POPS+IYS improved teacher-reported self-regulation compared with HS+POPS (P < .001) and HS (P < .001), but there was no effect on the prevalence of obesity (16.4% preintervention to 14.3% postintervention in HS+POPS+IYS versus 17.3% to 14.4% in HS+POPS [P = .54] versus 12.2% to 13.0% in HS [P = .33]). There was no effect of HS+POPS compared with HS alone (P = .16). There was no effect on other outcomes except for sugar-sweetened beverage intake (HS+POPS+IYS resulted in a greater decline than HS; P = .005). CONCLUSIONS: An intervention for parents and children to improve HS preschoolers' emotional and behavioral self-regulation in combination with an obesity-prevention curriculum did not reduce obesity prevalence or most obesity-related behaviors.
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