Environmental Influences on Early Childhood Obesity

Study Overview
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Brief Summary
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Few treatments have been developed for young children with obesity from diverse backgrounds. The present study will develop and test an intervention designed to improve preschool obesity in Latino children. The intervention will focus on improving eating, activity, and sleep behaviors and the home environment for improved weight status.

Detailed Description
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Children from low income families of minority status are at greater risk for development of obesity. There are no known existing treatments for pediatric obesity that focus on improving parental behaviors and the home food and activity environment. The objective of this study will be to address this limitation by developing and testing a novel treatment for low-income minority families. The objective will be attained by testing the following hypothesis: A parent-focused, home-based treatment aimed at improving parental feeding behaviors, child exposure to fruits and vegetables, and the home food and activity environment will result in significantly greater decrease in percent overweight / obesity compared to recommended practice. The hypothesis will be tested by using the approach of a pilot randomized control trial (RCT). The rationale for this aim is that success of the planned research will derive a treatment package that will provide the basis for the RCT. The planned research is expected to show the level of impact of changing parental feeding behaviors and the home environment on childhood overweight / obesity.

Official Title
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Environmental Influences on Early Childhood Obesity: The Healthy Homes Study

Conditions
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Childhood Obesity

Intervention / Treatment
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* Behavioral: Healthy Homes
* Other: Usual Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: mothers will identify themselves as being Latino obese preschool children will be required to have a BMI percentile at or above the 95th percentile, based on sex specific, BMI-for-age population referenced growth charts participating children will be required to have at least one primary caregiver who is English-speaking as their primary language and live within 50 miles of the UCD for the initial treatment development phase (n=3) and at least one family who is Spanish speaking (n=1). However, all families participating in the randomized portion can also be exclusively Spanish speaking. Exclusion Criteria: Children with medical conditions known to promote obesity will be excluded along with individuals involved with a weight-control program or those taking appetite-affecting medications Children who are greater than 100% overweight Children will be excluded who have a reported disability, illness, or disorder that would significantly affect diet or activity behaviors children identified by parents with significant food allergies involvement with Stage II, structured weight management for obesity.

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Healthy Homes<br>Behavioral Intervention | Behavioral: Healthy Homes<br>* The Healthy Homes Behavioral Intervention (HHBI) will be delivered during 8 sessions over 10 weeks using home visitations. The first 6 sessions occur weekly and provide education about healthy dietary intake including caloric recommendations for preschool aged children, healthy sleep goals, active play and screen time limits, and family routines and organization. Each session will include a parent-child interaction component to teach child behavior management skills related to intervention goals. Two final sessions occur every other week to provide problem solving and planning for maintenance of treatment effects.<br>|
| Active Comparator: Usual Care<br>Counseling session delivered by pediatrician | Other: Usual Care<br>* A pediatrician with experience delivering weight management treatment to children will deliver a single session, 1-hour treatment to families. Content to be delivered during the session will include lifestyle recommendations currently recommended by the AAP.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in BMI | BMI and % over the 95th percentile will be determined using scales | Baseline, 2.5 months, 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Caregiver's Feeding Styles Questionnaire | Change in type of parental feeding style over time | Baseline, 2.5 months, 12 months | 
| Change in Child caloric intake | 24 hour dietary recall will identify average daily caloric intake | Baseline, 2.5 months, 12 months | 
| Change in Sleep duration | Accelerometer will be used to determine objective estimates of sleep duration | Baseline, 2.5 months, 12 months | 
| Change in Home sleep environment | change in sleeping environment characteristics that promote healthy sleep | Baseline, 2.5 months, 12 months | 
| Change in Home food environment | change in home food environment characteristics that promote healthy food intake. | Baseline, 2.5 months, 12 months |