Promoting Healthy Development With the Recipe 4 Success Intervention
Condition: Obesity; Poverty
Study type: Interventional

Summary: 
      10-session home visit intervention conducted within Early Head Start and designed to reduce
      low-income toddler's obesity risk and improve their self-regulation skills and parents'
      sensitivity.
    

Detailed description: 
      Recipe 4 Success, the product of a university-community engagement collaboration, uses 10
      tightly sequenced, structured, and scripted food preparation lessons, delivered as part of
      Early Head Start home visits, to help low-income parents learn to sensitively scaffold their
      toddler's self-regulation skills and establish more healthy eating habits. The intervention
      relies on an active coaching therapeutic approach to deliver content. Recipe 4 Success is
      focused on parents because their feeding practices influence children's diet, and
      interventions to prevent childhood obesity are most likely to have long-term effects when
      they emphasize positive parenting practices. Parents' sensitivity and constructive
      scaffolding behaviors are related to children's self-regulation skills, which are robust
      predictors of healthy eating habits and body mass index (BMI). For example, children who have
      difficulty with self-regulation by age 3 have a higher BMI through age 12. Importantly, these
      relations may be causal: Adults who are taught self-regulation skills appear more successful
      in maintaining healthy eating habits over time. As a preventive intervention, Recipe 4
      Success is implemented when children are 2, the point at which deliberate self-regulation
      skills are starting to emerge and develop rapidly and taste preferences are being formed.
      Recipe 4 Success is designed for families living in poverty because parents are less likely
      to provide sensitive scaffolding and children are less likely to display well-developed
      self-regulation skills and healthy eating habits under conditions of economic adversity.
      Finally, Recipe 4 Success was created to be integrated into Early Head Start to expedite
      wide-spread dissemination and easy sustainability and to enhance the efficacy of this
      nation-wide home visit program. If successful, this will be one of the first preventive
      interventions to improve either toddler's self-regulation skills or their healthy eating
      habits and BMI.
    

Intervention name(s): Recipe 4 Success; Treatment as Usual Early Head Start
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Recipe 4 Success intervention consisted of 10 weekly lessons in which parents and toddlers prepared simple snacks or meals.
All Recipe 4 Success lessons started and ended with some evidence-based information for the parents about children's self-regulation skills or healthy eating habits. Most of each lesson in Recipe 4 Success was devoted to the snack or meal preparation activities. Each week, home visitors coached the parents as they worked with their toddlers to make increasingly challenging snacks and meals. During these activities, home visitors pointed out opportunities for parents to practice sensitive scaffolding strategies. At the same time, these meal and snack preparation activities allowed children to practice multiple age-appropriate self-regulation skills.; Treatment as Usual Early Head Start consisted of an evidence-based curriculum (usually Parents as Teachers) in which home visitors and parents worked with children on activities to support their physical, cognitive, and social-emotional development.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 2-arm randomized controlled trial comparing new home visit intervention delivered within Early Head Start to treatment as usual Early Head Start
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention