Family-based Nutrition Education. Part 3
Reducing sedentary behavior, increasing activity and eating an appropriate number of calories with a diet that is low in fat and simple sugars is the best way to manage weight. Approximately 20% of children aged 8 to 16 years exercise twice a week or less and 67% of children watch more than 2 hours of television per day (Jonides, Buschbacher, & Barlow, 2002). In addition, food preferences have changed and children today prefer and choose sweet and high fat foods more often (Birch & Fisher 1998). The imbalance between eating and activity behavior is a major contribution to the pediatric overweight epidemic and is influenced by many interrelated factors. Story, Neumark-Sztainer, and French, (2002) describe factors that influence behavior as individual (psychosocial and behavioral factors), social environmental (family, friends and peer networks), physical environmental (schools, fast-food and vending machines) and macrosystem (social and cultural norms, mass media and government policies). Interventions need to target multiple areas at both the individual and environmental levels to initiate change.
At the Conference on Preventing Childhood Obesity in December 2002, experts in the field identified parents as being an effective target population for intervention regarding childhood obesity (Lederman, Akabas, Moore, Bentley, Devaney, Gillman, et al, 2004). Birch and Fisher (1998) reported parental influences most associated with risk of overweight among children are availability and accessibility of food, direct modeling, the extent of media exposure in the home, and interactions surrounding eating. It has been indicated that family-based weight management programs that include both parent and child involvement and target behaviors related to eating and activity behavior are a logical and effective approach for the prevention and treatment of overweight in children (Kibbe & Offner, 2003; St. Jeor, Perumean-Chaney, Sigmund-Grant, Williams, & Foreyt, 2002).
The intent of this study is to evaluate short-term outcomes of a family-based lifestyle change intervention, Lifelong Eating and Activity Patterns (LEAP), as an effective approach for the prevention and treatment of childhood overweight and to initiate lifestyle changes that promote healthy eating and activity patterns for the whole family. The research hypothesis is that there is a significant difference between pre and post BMI, percent body fat, fitness level and eating and activity behaviors for child and parent participants.
Methods
Subjects and Methods of Selection
Of the 174 participants initially enrolled in the program, 107 (64%) children ages 7-14 completed the LEAP program with one or both of their parents (n=94) between June 2002 and August 2004. Completion of the program constituted attendance at a minimum of six of the eight weekly sessions provided. The number of parents is less than the number of child participants as several families had more than one child participate. The majority of the program participants was low-income and was referred to the LEAP program by their primary healthcare provider. The child participants were either “at risk for overweight” (n=3, 3%) or “overweight” (n=104, 97%) as defined by the CDC definitions of BMI-for-Age percentile of 85-94.99% or >95th percentile, respectively. The California State University, Chico Human Subjects Committee approved this research in the spring of 2001.