title: Healthy feeding habits: efficacy results from a cluster-randomized, controlled exploratory trial of a novel, habit-based intervention with parents.
abstract: BACKGROUND
  As dietary gatekeepers for young children, parents are often the proximal target of family-based dietary interventions. Habit theory offers a novel approach to modifying parental feeding, based on "context-dependent repetition" to promote automatic responding and to reduce decisional conflict.
  
  
  OBJECTIVE
  This exploratory trial evaluated an intervention promoting habit formation for 3 parental feeding behaviors: serving fruit/vegetables, serving healthy snacks, and serving nonsweetened drinks. The primary outcome was parental habit strength for each behavior. The secondary outcome was children's food intake.
  
  
  METHODS
  Parents of children aged 2-6 y (n = 126) were recruited from 6 children's centers in London and cluster-randomized to intervention (n = 3) or no-treatment control (n = 3) conditions. Parents in the intervention group (n = 58) received training on habit formation for 3 feeding behaviors; control participants (n = 68) were asked only to complete the measures. At baseline and after treatment, parents completed validated measures of subjective "automaticity" for feeding behaviors and a brief child food-frequency measure. Parents in the intervention group were interviewed about the program. The change between groups, after clustering was controlled for, was analyzed.
  
  
  RESULTS
  For all parental feeding behaviors, automaticity increased more in the intervention group than in the control group (P < 0.01 for all). Significant intervention effects on children's intake of vegetables (P = 0.003), healthy snacks (P = 0.009), and water (P = 0.032) were observed. Changes in children's food intake correlated with changes in parental automaticity of feeding behaviors, and program acceptability was high.
  
  
  CONCLUSIONS
  A habit-based intervention successfully modified parental feeding behaviors, affected children's diets positively, and was well received by parents. Habit theory provides a promising new tool to support family-based obesity prevention. This trial was registered as ISRCTN09910187.
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: McGowan
authors.forename: Lucy J
authors.initials: LJ
authors.lastname: Cooke
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gardner
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Beeken
authors.forename: Helen
authors.initials: H
authors.lastname: Croker
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000328:Adult; D002652:Child Behavior; D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D016487:Parenting; D010290:Parents; D017060:Patient Satisfaction; D062410:Snacks; D014675:Vegetables; D014867:Water
chemical_list: D014867:Water