Intervention INC: An Interactive Family-centered mHealth Tool to Reduce Obesity Risk in Urban Minority Preadolescents

Intervention INC: An Interactive Family-centered mHealth Tool to Reduce Obesity Risk in Urban Minority Preadolescents

Intervention INC: An Interactive Family-centered mHealth Tool to Reduce Obesity Risk in Urban Minority Preadolescents

Children's Aid, CUNY Graduate School of Public Health and Health Policy, Brown School at the Washington University of St. Louis, University of Massachusetts, Amherst, Agency for Healthcare Research and Quality (AHRQ)

Using a two-group randomized study design, this study aims to evaluate the effectiveness of the adapted family-centered mHealth tool on child BMI z-score (primary outcome), child dietary behaviors, and parental feeding practices, from baseline to 12-month follow-up, among 200 child-parent dyads. It is hypothesized that children in the experimental group will demonstrate larger BMI-z score improvements between baseline and 12-month follow-up compared to children in the comparison group.

Childhood obesity continues to be a serious clinical and public health issue in the United States (US), particularly within low-income, minority groups. Effective, yet engaging interventions, such as the one developed by our team, are needed to capture the attention of children living in a multi-media environment. Potentially eligible pediatric patients (and their parent/caregiver) will be recruited from two of Children's Aid community-based clinics in NYC - Dunlevy Milbank Center based in Harlem and the Bronx Health Center based in the South Bronx. A variety of recruitment methods will be deployed, including mailed letters, direct calls, and in-person/flyer-based recruitment in clinic waiting rooms. At baseline, eligible participants will be randomized to either the experimental group or comparison group (allocation ratio 1:1). Randomization will be performed at the dyad level and will be balanced on child ethnicity (Hispanic or Non-Hispanic), BMI category (overweight, obese), gender (male, female, other), and clinic site. The experimental group will receive access to Intervention INC, a theory-guided interactive, family-centered web-based tool promoting healthy dietary behaviors. The intervention will be individually tailored based upon an initial self-assessment tailoring algorithm of the participating child-parent dyad. The comparison group will receive access to web-based newsletters focused on promoting healthy dietary behaviors. To minimize bias, participants will be blinded to the study's hypothesis. Data will be collected at four timepoints: baseline (T1), main intervention end (T2), maintenance intervention end (T3), and at 12-month follow-up (T4). The primary outcome measure (BMI z-score) will be calculated using height and weight data captured via combined scale/stadiometer by a trained healthcare provider at T1, T3, T4. Secondary measures (dietary intake and dietary knowledge & attitudes of child participants; feeding practices and the home food environment by the parent/caregiver) will be captured via questionnaires at T1, T2, T3, T4.

The experimental group will receive access to Intervention INC, a theory-guided interactive, family-centered web-based tool promoting healthy dietary behaviors.

The comparison group will receive access to web-based newsletters focused on promoting healthy dietary behaviors.

T1 (baseline), T3 (maintenance intervention end, 6 months post-T2), T4 (follow-up, 12 months post T2)

17-item questionnaire completed by child participants assessing frequency of consumption of fruit/vegetables, water, junk food, and sugary drinks during the past seven days

T1 (baseline), T2 (intervention end, 12-weeks post-baseline), T3 (maintenance intervention end, 6 months post-T2), T4 (follow-up, 12 months post T2)

45-item questionnaire completed by child participants assessing knowledge, outcome expectations, self-efficacy, and behavioral intention regarding behaviors associated with fruit/vegetables, water, junk food, and sugary drinks

T1 (baseline), T2 (intervention end, 12-weeks post-baseline), T3 (maintenance intervention end, 6 months post-T2), T4 (follow-up, 12 months post T2)

T1 (baseline), T2 (intervention end, 12-weeks post-baseline), T3 (maintenance intervention end, 6 months post-T2), T4 (follow-up, 12 months post T2)

6-item questionnaire completed by parent participants assessing availability of fruits/vegetables and water in their home and how often they store fruits/vegetables and water in a place easily seen by their child

T1 (baseline), T2 (intervention end, 12-weeks post-baseline), T3 (maintenance intervention end, 6 months post-T2), T4 (follow-up, 12 months post T2)

Inclusion Criteria (child): self-identifies as Black/African-American and/or Latino between ages 9 and 12 years (preadolescents) at time of scheduled baseline visits reads and speaks in English has a Body Mass Index percentile at or above 85% at baseline (categorized as overweight or obese) has regular internet access via a tablet device, smartphone, or computer/laptop has regular access to a phone with texting capability is comfortable reading/viewing material on electronic devices is comfortable speaking with study staff about thoughts/experiences while participating in study has a legal parent/guardian willing to participate in study Inclusion Criteria (parent): legal parent/guardian of child willing to participate in study reads and speaks in English or Spanish primarily responsible for preparing/purchasing food for child has regular internet access via a tablet device, smartphone, or computer/laptop has regular access to a phone with texting capability comfortable reading/viewing material on electronic devices able to attend in-person study visits and complete online questionnaires with their child over the full duration of study Exclusion Criteria (child): has allergies, food aversions, food disorders, or medications with side-effects that may impact participation in study has a pacemaker or heart condition in foster care