Early childhood family intervention and long-term obesity prevention among high-risk minority youth.
OBJECTIVE
To test the hypothesis that family intervention to promote effective parenting in early childhood affects obesity in preadolescence.


METHODS
Participants were 186 minority youth at risk for behavior problems who enrolled in long-term follow-up studies after random assignment to family intervention or control condition at age 4. Follow-up Study 1 included 40 girls at familial risk for behavior problems; Follow-up Study 2 included 146 boys and girls at risk for behavior problems based on teacher ratings. Family intervention aimed to promote effective parenting and prevent behavior problems during early childhood; it did not focus on physical health. BMI and health behaviors were measured an average of 5 years after intervention in Study 1 and 3 years after intervention in Study 2.


RESULTS
Youth randomized to intervention had significantly lower BMI at follow-up relative to controls (Study 1 P = .05; Study 2 P = .006). Clinical impact is evidenced by lower rates of obesity (BMI ≥95th percentile) among intervention girls and boys relative to controls (Study 2: 24% vs 54%, P = .002). There were significant intervention-control group differences on physical and sedentary activity, blood pressure, and diet.


CONCLUSIONS
Two long-term follow-up studies of randomized trials show that relative to controls, youth at risk for behavior problems who received family intervention at age 4 had lower BMI and improved health behaviors as they approached adolescence. Efforts to promote effective parenting and prevent behavior problems early in life may contribute to the reduction of obesity and health disparities.
New York University Child Study Center, Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA. laurie.brotman@nyumc.org
Laurie Miller
LM
Brotman
Spring
S
Dawson-McClure
Keng-Yen
KY
Huang
Rachelle
R
Theise
Dimitra
D
Kamboukos
Jing
J
Wang
Eva
E
Petkova
Gbenga
G
Ogedegbe
D000293:Adolescent; D000367:Age Factors; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000502:physiology*; D002675:Child, Preschool; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008913:Minority Groups; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control* / Q000628:therapy; D010287:Parent-Child Relations; D016487:Parenting / Q000208:ethnology; D010290:Parents / Q000193:education; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors