Nurturing Needs Study: Parenting Food Motivated Children

Study Overview
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Brief Summary
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High food motivation among children is trait-like and increases risks of unhealthy dietary intake and obesity. Scientific knowledge of how parenting can best support healthy eating habits and growth among children who are predisposed to overeating is surprisingly limited. This investigation will identify supportive food parenting approaches for obesity prevention that address the needs of highly food motivated children.

Detailed Description
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High levels of food motivation among young children are heritable, track over time, and associated with elevated risks of unhealthy eating and obesity. Despite significant growth of family-based obesity prevention efforts, the evidence base is remarkably scant on parenting highly food motivated children to prevent obesity and poor dietary outcomes. The need to move away from a one-size-fits-all approach to food parenting is particularly pronounced for children from racial and ethnic minority families with low income that experience greater disparities in obesity, are underrepresented in the food parenting and family-based prevention literatures, and for whom prevention efforts have had limited success to date. The goal of this investigation is to generate a robust basic science evidence for parenting highly food motivated children to prevent excessive dietary intakes and body mass index (BMI) gains during the preschool years among racial and ethnic minority families with low incomes. Using a prospective cohort design, this investigation follow 375 Hispanic and Black caregiver/child dyads with low incomes over 18 months as children transition from preschool to elementary school, when significant numbers of children begin to experience problems of poor diet quality and obesity. Children with varying food motivation will be recruited to understand whether highly food motivated children have different needs than other children. A multi-method approach will use state-of-the-art measures, including ecological momentary assessment, to comprehensively investigate the amount, types, and consistency of food parenting practices (i.e., specific, goal-oriented behaviors) needed to prevent food motivated behaviors, excessive dietary intake, and BMI gains in children. Specifically, the role of structure (i.e., theoretically supportive) and its differentiation from more coercive types of food parenting control will be comprehensively characterized.

Official Title
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Deconstructing Food Parenting Approaches to Obesity Prevention for the Highly Food Motivated Child

Conditions
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Parenting, Eating Behavior, Diet, Healthy, Pediatric Obesity

Intervention / Treatment
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* Other: Measurement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hispanic or Black parent/primary caregiver race/ethnicity, based on the participating caregiver's self-disclosure; Low household income, based on US poverty income guidelines for WIC/Head Start eligibility; Child ages 4 or 5 years at baseline; Parent/ primary caregiver with legal representation (having 50% or more custody of child); Parent/primary caregiver reporting primary responsibility for child feeding outside of childcare (being with child when they are eating at least two times daily); Caregiver with a cell phone that can be used to send and receive text messages. If there is more than one age-eligible child in the family, we will ask the caregiver to pick the index child. Exclusion Criteria: Parent/primary caregiver <18 years of age; Child history of major food allergies (e.g., peanuts); Child medication use (e.g., insulin), developmental disability (e.g., autism) or medical condition(s) (e.g., diabetes) known to affect food intake and growth; Foster child.

Ages Eligible for Study
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Minimum Age: 4 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: Other
Intervention Model: Single Group Assignment
Interventional Model Description: Family-based, prospective observational study with interventions at the measurement level
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Caregiver-child dyads<br>A cohort of 375 caregivers and 375 children aged 4-5 years at baseline will be recruited and followed longitudinally for 18 months. | Other: Measurement<br>* The only interventions are at the measurement level and consist of two behavioral protocols designed to assess children's eating behavior, where food stimuli are provided and children's behavioral responses are recorded.<br>* Other names: Relative reinforcing value of food;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Excessive dietary intakes | Indicators: SFAS intakes and meal/snack sizes estimated from 24-hour dietary recalls | Baseline, 18 months | 
| BMI change | % of the 50th percentile per age- and sex-specific CDC reference values for BMI on a log scale | Baseline, 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Observed food motivated behaviors | Indicators: Eating in the absence of hunger and relative reinforcing value of food | Baseline, 18 months |