Healthy Habits, Happy Homes: An Intervention to Improve Household Routines for Obesity Prevention (HH)
While childhood obesity rates may have plateaued in some US population subgroups, such as whites and those of higher socioeconomic status, overall rates of obesity remain high and racial/ethnic and socioeconomic disparities appear to be widening. Among the most promising approaches for childhood obesity prevention and management are interventions that begin early in life and that support change at the individual and community levels.
The goal of this project is to develop and test an intervention delivered to racial/ethnic minority and low income parents of 2-5 year old children in their homes, designed to promote adoption of household routines and parenting strategies that are preventive of obesity. To achieve this goal, the investigators will work with community health centers in Boston, Cambridge, and Somerville to recruit families to participate in an individual-level randomized controlled trial. The investigators partner community health centers include the Roxbury Comprehensive Community Health Center, Dimock Community Health Centers, and the Cambridge Health Alliance (CHA).
Participants will be randomized to receive either 1) mailed educational materials for the duration of the 6-month program (control), or 2) home-based health coaching visits and phone calls with a health educator, text messages, and educational materials promoting the adoption of household routines and target behaviors (intervention).
The investigators goal is to evaluate the feasibility and effectiveness of the investigators designed intervention (as compared to the control condition) using baseline and post-intervention data. In order to do so, the investigators will assess change from baseline to post-intervention in the investigators key behavioral outcomes of interest, including adoption of three household routines:
- Regularly eating meals together as a family
- Obtaining adequate sleep
- Limiting screen-viewing time
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
|Official Title:||Healthy Habits, Happy Homes: An Intervention to Improve Household Routines for Obesity Prevention|
- Parent and child health behaviors [ Time Frame: Baseline, 6 months ] [ Designated as safety issue: No ]
Using parent self-report surveys, we will assess change from baseline to post-intervention in parent and child behaviors related to the following health outcomes:
- TV viewing, including TV in the room where the child sleeps, time spent watching TV, total screen time
- Sleep, including parent and child sleep duration and presence of a calming nighttime routine
- Diet, including eating meals together as a family, lowering intake of fast food, and lowering intake of sugar-sweetened beverages
- TV Viewing Time [ Time Frame: Baseline, 6 months ] [ Designated as safety issue: No ]
Using two separate measures of Child TV viewing time (parent-report and measured TV time using the TV Allowance device, we will assess change from baseline to post-intervention in the amount of TV the child watches.
Additionally, using parent-report surveys we will assess change from baseline to post-intervention in total screen time as well as observed presence of TV in the room where the child sleeps.
- Child height and weight measurements [ Time Frame: Baseline, 6 months ] [ Designated as safety issue: No ]We will assess change in child BMI and BMI z-score from baseline to post-intervention using in-person child height and weight measurements, taken by trained research staff using a standing Schorr board to measure height and an electronic scale to measure weight.
- Cognitive stimulation in the home [ Time Frame: Baseline, 6 months ] [ Designated as safety issue: No ]We will assess change from baseline to post-intervention in total score on the STIMQ, a validated instrument that captures the presence of cognitive stimulation in the home. This instrument is administered as an in-person interview with the primary caregiver.
- Presence of media devices in the home [ Time Frame: Baseline, 6 months ] [ Designated as safety issue: No ]We will assess the home environment at baseline and post-intervention, using a developed instrument called the Home Environment Media Inventory (HEMI). From this, we will be able to observe change from baseline to follow up in the presence of media devices in the home, as well as basic neighborhood and household characteristics. Media devices measured include: TV, DVD, DVR/Tivo, Cable, and Computer.
- Use of mobile technology [ Time Frame: Baseline ] [ Designated as safety issue: No ]We will assess the participant's use of mobile technology at baseline, such as text messaging and downloaded applications, as well as whether participants have had their cell service cut off for any reason.
|Study Start Date:||September 2009|
|Estimated Study Completion Date:||September 2012|
|Estimated Primary Completion Date:||August 2012 (Final data collection date for primary outcome measure)|
Experimental: Home-Based Health Coaching
Intervention delivered in the home.
Behavioral: Home-Based Health Coaching
The 6-month intervention arm consists of 3 components:
Other Name: Healthy Habits, Happy Homes Health Coaching
Active Comparator: Control Arm
Mailed educational materials
Behavioral: Mailed materials
We designed materials for our control group focusing on Developmental milestones during early childhood to provide information that participants would find relevant and helpful for parenting, but that would also not influence intervention behaviors, such as TV viewing or household routines related to sleeping, eating, or television viewing.
Participants received 4 monthly mailing packages, each focusing thematically on one of four milestone domains: motor, language, cognitive and social/emotional. Educational materials were adapted from the Center for Disease Control's "Positive Parenting Tips for Healthy Child Development", and the mailing included child-appropriate incentives to reinforce the concepts presented in the educational materials.
Other Name: Healthy Habits, Happy Homes mailed materials
|United States, Massachusetts|
|Harvard Pilgrim Health Care|
|Boston, Massachusetts, United States, 02215|
|University of Guelph|
|Guelph, Ontario, Canada, N1G 2W1|
|Principal Investigator:||Elsie Taveras, MD, MPH||Harvard Pilgrim Health Care|
|Study Director:||Julia McDonald, MS, MPH||Harvard Pilgrim Health Care|