title: The use of mentoring programs to improve energy balance behaviors in high-risk children.
abstract: This study tested the impact of a multicomponent intervention entitled "Partners of all Ages Reading About Diet and Exercise" (PARADE) a child-focused energy balance intervention incorporated into mentoring programs. We used a group randomized nested cohort design randomizing mentoring program sites (n = 119) and children (N = 782; females = 49%; African American = 37%; mean (s.d.) age = 8.5 (1.5) years) to intervention or usual care conditions. PARADE mentors delivered eight lesson plans addressing key concepts related to diet and activity; eight child-focused computer-tailored storybooks with messages targeting that child's diet and activity patterns and eight parent action support newsletters. When compared to the control group, PARADE children were more knowledgeable of diet and activity guidelines (P < 0.01), challenged themselves more to eat five fruits and vegetables (FV) (P < 0.01) and be active 1 h daily (P < 0.01), and to ask for FV for snack (P = 0.015). Calories from high fat foods decreased in overweight/obese children, but not for normal weight children (P = 0.059). There were no significant differences in fruit and vegetable intake, total calories, percent time being active, or BMI z-score. The combination of one-to-one mentoring, child-focused computer based tailoring, and parent support may impact important behavioral change precursors in environments over which the child has control, especially among normal weight children. Further, work is needed to evaluate the impact of family-focused multicomponent interventions, including computer-tailored approaches, directed toward both the parent and the child.
authors.affiliation: Brown School of Social Work, Washington University, St Louis, Missouri, USA. djoshu@gwbmail.wustl.edu
authors.forename: Debra
authors.initials: D
authors.lastname: Haire-Joshu
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Nanney
authors.forename: Michael
authors.initials: M
authors.lastname: Elliott
authors.forename: Cynthia
authors.initials: C
authors.lastname: Davey
authors.forename: Nicole
authors.initials: N
authors.lastname: Caito
authors.forename: Deborah
authors.initials: D
authors.lastname: Loman
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Kreuter
mesh_terms: D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008611:Mentors; D009043:Motor Activity / Q000502:physiology; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D040242:Risk Reduction Behavior