Development of a Family Focused Child Obesity Prevention Program for Preschoolers—SEEDS

Introduction: Childhood obesity rates are higher among low-income families and increase in weight velocity between ages 2 and 5 is the strongest predictor of adult obesity. As a result, interventions that engage low-income families with preschoolers are a high priority for combatting childhood obesity.

Intervention: SEEDS is a family-based intervention based on self-determination theory. Data from family mealtime observations and focus groups were used to inform curriculum development for separate parent, child, and family sessions. Content of parent sessions included: developing children’s food preferences, recognizing internal cues of hunger and fullness, determining appropriate portion sizes for preschoolers, recognizing environmental influences on eating, and structuring family meals and routines. Twelve videos were developed to facilitate parent discussion. Child sessions included activities focused on trying new foods and identifying internal cues of fullness. Family sessions reinforced learning from individual sessions. Curriculum materials were produced in both English and Spanish.

Methods: The program is being evaluated through a randomized, controlled trial design at two sites with assessments at pre, post, 6 months post, and 12 months post-program. Child assessments include taste preferences, caloric compensation, and Eating in the Absence of Hunger. Parent assessments include parent report of feeding, acculturation, child eating behaviors, child food preferences, and child intake. Height/weight measures are also collected. Each trial lasts seven weeks with 8 to 10 families enrolled each in the prevention arm and control arm. To date, 188 families (98 prevention and 90 control) have participated. Data collection will continue through 2016.

Results: Preliminary analyses on pre- and post-test assessments showed promising results. Parent-reported responsiveness to children’s cues during feeding was significantly improved from pre-test to post-test for prevention parents compared to controls (p < .001). Parent-reported monitoring (p < .08), autonomy promotion (p < .08), promoting internal control of eating (p < .001), and offering new foods (p < .02) were also significantly or near significantly improved for prevention parents. In addition, parent-reported pressuring the child to eat was significantly reduced for prevention parents (p < .03).

Conclusions: Few comprehensive obesity prevention programs currently exist that focus on child self-regulation of eating, the exploration of novel foods, and the role that parents play in the socialization of child eating behaviors. The SEEDS program is one such prevention program. The final results for the efficacy trial with Latino families will be available for conference presentation.