One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial.
BACKGROUND
The purpose of this study was to evaluate the efficacy of the Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention at 1-year, postintervention follow-up.


METHODS
A mixed between-within subjects design was used to evaluate the trial. Independent variables included a two-level, group assignment: EMPOWER (experimental intervention) based on social cognitive theory (SCT) as well as a knowledge-based intervention Healthy Lifestyles (active control intervention). Dependent variables were evaluated across four levels of time: baseline (Week 0), posttest (Week 4), 1-month follow-up (Week 8), and 1-year follow-up (Week 60). Dependent variables included five maternal-facilitated SCT constructs (environment, emotional coping, expectations, self-control, and self-efficacy) as well as four child behaviors (minutes of child physical activity, cups of fruits and vegetables consumed, 8-ounce glasses of sugar-sweetened beverages consumed, and minutes of screen time). Null hypotheses implied no significant group-by-time interactions for the dependent variables under investigation.


RESULTS
A significant group-by-time interaction for child fruit and vegetable consumption was found in the experimental group (p = .012) relative to the control group. At 1 year, results suggested an overall increase of 1.847 cups of fruits and vegetables (95% confidence interval = 1.207-2.498) in the experimental group (p < .001). Analysis suggested changes in the maternal-facilitated home environment accounted for 13.3% of the variance in the change in child fruit and vegetable consumption. Improvements in child physical activity, sugar-free beverage intake, and screen time first detected at 1-month follow-up in both groups were no longer significant at 1-year follow-up.


CONCLUSIONS
An online family-and-home-based intervention was efficacious for improving child fruit and vegetable consumption. Follow-up booster sessions may assist in maintaining treatment effects.
University of Alabama, Tuscaloosa, AL, USA aknowlden@ches.ua.edu.
Adam
A
Knowlden
Jackson State University, Jackson, MS, USA.
Manoj
M
Sharma
D002648:Child; D002668:Child Rearing; D002675:Child, Preschool; D020375:Education, Distance / Q000379:methods*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D009034:Mother-Child Relations; D063766:Pediatric Obesity / Q000517:prevention & control*
family-based intervention; mother–child dyad; online intervention; overweight prevention; social cognitive theory