Abstract
OBJECTIVE: To test the feasibility, acceptability and preliminary impact of Parents and Tots Together (PTT), a family-based obesity prevention intervention, in Canada.
PARTICIPANTS: Canadian parents of preschoolers (aged 2–5 years).
SETTING: Ontario Early Years centres in southwestern Ontario.
INTERVENTION: A pilot randomized controlled trial involving 48 parents who received either the PTT intervention (n = 27) or an attention-matched control home safety intervention (n = 21). To evaluate the feasibility of PTT, we assessed participant retention and outcome evaluation completion rates. To evaluate acceptability, we assessed program attendance and parents’ responses to program satisfaction surveys. To evaluate preliminary impact, we assessed children’s body mass index (BMI) at baseline, after intervention (end of 9-week intervention) and at 9-month follow-up. As well, at each time point, parents completed surveys assessing stress and self-efficacy related to parenting, children’s sleep, activity, TV viewing and diet.
OUTCOMES: Retention rates were high in the intervention (93%) and control (84%) study arms, and 87% of parents reported that they would highly recommend PTT to a friend. At 9-month follow-up, intervention parents reported lower parenting stress β̂ = 15.83, 95% confidence interval [CI] −29.57, −2.07, p = 0.02) and greater self-efficacy in managing their child’s behaviour (β̂ = 0.16, 95% CI 0.002, 0.33, p = 0.05) than control parents. PTT had minimal influence on children’s weight-related behaviours and BMI.
CONCLUSIONS: The results suggest that PTT can feasibly be implemented and tested in the Canadian context. Preliminary impact results suggest that the program may be effective in changing general parenting; however, program content should be modified to adequately address children’s weight-related behaviours.
Keywords: Childhood, obesity prevention, family-based intervention
Résumé
OBJECTIF : Tester la faisabilité, l’acceptabilité et l’impact préliminaire de Parents and Tots Together (PTT), une intervention de prévention de l’obésité menée auprès des familles au Canada.
PARTICIPANTS : Des parents canadiens d’enfants d’âge préscolaire (2–5 ans).
LIEU : Les Centres de la petite enfance du Sud-Ouest de l’Ontario.
INTERVENTION : Un essai pilote comparatif randomisé auprès de 48 parents ayant reçu soit l’intervention PTT (n = 27), soit une intervention-témoin sur la sécurité à domicile de même niveau d’attention (n = 21). Pour déterminer la faisabilité de PTT, nous avons évalué les taux de conservation des participants et leur taux de réponse aux questionnaires d’évaluation des résultats. Pour déterminer l’acceptabilité, nous avons évalué la fréquentation du programme et les réponses des parents aux sondages sur leur satisfaction par rapport au programme. Pour déterminer l’impact préliminaire, nous avons évalué l’indice de masse corporelle (IMC) des enfants au départ, après l’intervention (au bout de 9 semaines) et lors du suivi après 9 mois. De plus, à chaque étape, les parents ont rempli des questionnaires évaluant leur stress et leur autoefficacité liés à leur rôle parental et au sommeil, à l’activité, à l’écoute de la télévision et au régime des enfants.
EFFETS : Les taux de conservation ont été élevés pour l’intervention (93%) et pour l’étude témoin (84%), et 87% des parents ont déclaré qu’ils recommanderaient vivement le programme PTT à un ami. Au suivi après 9 mois, comparativement aux parents témoins, les parents de l’intervention ont fait état d’un stress moins élevé lié au rôle parental (β̂ = 15,83, intervalle de confiance [IC] de 95%: −29,57, −2,07, p = 0,02) et d’une autoefficacité plus élevée dans la gestion du comportement de leur enfant (β̂ = 0,16, IC de 95%: 0,002, 0,33, p = 0,05). Le programme PTT n’a eu qu’une influence minime sur les comportements liés au poids et sur l’IMC des enfants.
CONCLUSIONS : Les résultats montrent qu’il est faisable de mettre en œuvre et de tester le programme PTT dans le contexte canadien. Les résultats sur l’impact préliminaire montrent que le programme peut être efficace pour changer les compétences parentales en général, mais qu’il faudrait en modifier le contenu pour aborder convenablement les comportements liés au poids chez les enfants.
Mots Clés: enfance, prévention de l’obésité, intervention familiale
Footnotes
Acknowledgements: We thank our colleagues from the Guelph Community Health Centre and Cambridge Ontario Early Years Centre for their insight and support regarding the implementation of this research.
Funding: Funding for this research was provided by the Danone Institute of Canada.
Conflict of Interest: Under an agreement between Rush University Medical Center and Dr. Deborah Gross, Dr. Gross is entitled to revenue from sales of the Chicago Parent Program. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. The authors have no further financial disclosures to declare.
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