The Phit Project: Pilot Study of a Multi-Systemic Early Childhood Obesity Intervention

Healthy weight is critical to preventing later health problems (Taveras et al., 2009). Children under five have had the largest increase in prevalence rates of obesity (Summerbell et al., 2005), which has been found to maintain over time (Mamun et al., 2009). Despite the need, there is a paucity of effective obesity interventions for children under 5 (Whitlock et al., 2005). The formative years of a child’s life are crucial as habits are formed, contingencies established, and parent-care provider relationships are created. Integrated interventions linking home, school, and medical settings have the potential to promote children’s optimal health (Weiner et al., 2012).

The PHIT Project addresses early childhood obesity through an interdisciplinary, innovative, multi-systemic (home, school, medical) approach. PHIT is a patient-centered, home visitation approach founded on an evidence-based (Guli, 2005; Sheridan et al., 2012) problem-solving model (Sheridan & Kratochwill, 2008) grounded in ecological systems theory that promotes environmental and behavioral changes across settings through an integrated implementation of evidence-based interventions. Using this approach, pediatric behavioral consultants work with families and teachers/daycare providers to promote children’s healthy habit formation through a structured, databased problem solving process. Our purpose is to examine preliminary outcome data from a subset of treatment children with multiple baseline data from the larger longitudinal randomized pilot study to demonstrate the potential efficacy of PHIT for addressing overweight and obesity for preschoolers from low-income families, who are disproportionately at risk for negative health outcomes over the lifespan.  

Case study data using concurrent multiple baseline design across behaviors (diet, activity, and sleep) for six children 3-5 years (83% male; M age = 4.54, SD = 1.15; 50% Latino, 50% Caucasian) identified as overweight or obese enrolled in the larger pilot study are currently being collected and will be presented. Graphic trends, Percentage of All Non-overlapping Data, and Conservative Dual Criterion analyses will be used to demonstrate PHIT’s effects on children’s healthy habits and zBMI. Preliminary descriptive data demonstrates that children in the PHIT intervention have decreased over-consumption of fatty or sugary foods, improved moderate activity, decreased sedentary time, and improved overall health status (i.e., zBMI).

These findings have significant implications for public health prevention efforts pointing to the relevance integrated multi-systemic (home, school, medical) interventions as being beneficial in reducing the incidence of early childhood overweight/obesity. Implications for research and practice will be discussed.