Development and Pilot Testing of a Home-Based Weight Maintenance Program for Toddlers and Families

Childhood obesity is as a major public health concern in the United States, with nearly 1 in 3 children considered overweight or obese. Unfortunately, there are few evidence-based programs that have achieved sustained behavior change in families to impact body weight, especially programs primarily targeting young children. While there are many risk factors for childhood obesity including health disparities, an emerging literature has identified the parent-child relationship and adverse early childhood experiences (e.g., child maltreatment) as important predictors of obesity. Parent training programs have been highly successful in reducing child mental health problems and child maltreatment risk, and experts agree that such programs hold promise for reducing children’s risk for obesity. Parent training programs have been found to reduce BMI percentile, despite having little to no content addressing nutrition or physical activity. Developing a parent training program optimizing two aspects of child development, child healthy eating and physical activity, and parent-child interactions and child health, is likely to promote healthy body weight trajectories for children later in life. This presentation will discuss the development of the DRIVE (Developing Relationships that Involve Values of Eating and Exercise) program. The DRIVE program is a family-focused, home-based program for families with young children who exhibit elevated weights (at or above the 75th percentile). DRIVE targets children between the ages of 2-6 years old, working with the parents as the “agent of change” to create a healthy home environment around eating, physical activity, and parent-child interactions. DRIVE is a 15 session program (over the course of 18 weeks), with the first 12 weekly sessions focused on specific topics (e.g., reducing sugar sweetened beverages, healthy food choices), while the remaining 3 bi-weekly sessions are focused on maintaining progress. A pilot project is currently underway to evaluate the feasibility and efficacy of DRIVE for families. 16 families have been randomized to either the DRIVE group or control group (who will receive information on nutrition, physical activity, and parenting via the mail) in a 1:1 ratio. All families completed a baseline assessment, mid-point assessment, and post assessment in their home, which assesses the child’s and a parent’s height, weight, and waist circumference; parent report of attitudes towards health and nutrition; parent and child food consumption; and parent and child physical activity levels. Data collection will conclude in December 2015. We will present the findings, as well as lessons learned and future directions.