Obesity prevention in preschool native-american children: a pilot study using home visiting.
OBJECTIVE
To determine whether maternal participation in an obesity prevention plus parenting support (OPPS) intervention would reduce the prevalence of obesity in high-risk Native-American children when compared with a parenting support (PS)-only intervention.


METHODS
Forty-three mother/child pairs were recruited to participate. Mothers were 26.5 +/- 5 years old with a mean BMI of 29.9 +/- 3 kg/m(2). Children (23 males) were 22 +/- 8 months old with mean weight-for-height z (WHZ) scores of 0.73 +/- 1.4. Mothers were randomly assigned to a 16-week OPPS intervention or PS alone. The intervention was delivered one-on-one in homes by an indigenous peer educator. Baseline and week 16 assessments included weight and height (WHZ score and weight-for-height percentile for children), dietary intake (3-day food records), physical activity (measured by accelerometers), parental feeding style (Child Feeding Questionnaire), and maternal outcome expectations, self-efficacy, and intention to change diet and exercise behaviors.


RESULTS
Changes in WHZ scores showed a trend toward significance, with WHZ scores decreasing in the PS condition and increasing among the OPPS group (-0.27 +/- 1.1 vs. 0.31 +/- 1.1, p = 0.06). Children in the OPPS condition also significantly decreased energy intake (-316 +/- 835 kcal/d vs. 197 +/- 608 kcal/d, p < 0.05). Scores on the restriction subscale of the Child Feeding Questionnaire decreased significantly in the OPPS condition (-0.22+/- 0.42 vs. 0.08+/- 0.63, p < 0.05), indicating that mothers in the OPPS group were engaging in less restrictive child feeding practices over time.


CONCLUSIONS
A home-visiting program focused on changing lifestyle behaviors and improving parenting skills showed promise for obesity prevention in high-risk Native-American children.
Harvey-Berino
Jean
J
Department of Nutrition and Food, Sciences University of Vermont, Burlington, Vermont 05405-0148, USA. Jean.Harvey-Berino@uvm.edu
Rourke
Janine
J
D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D053198:Child Nutrition Sciences / Q000193:education*; D002675:Child, Preschool; D015930:Diet Records; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007198:Indians, North American; D007223:Infant; D008297:Male; D009035:Mothers; D009765:Obesity / Q000517:prevention & control*; D016487:Parenting; D010865:Pilot Projects