BackgroundLittle is known about preschool parents’ cognitions, barriers, supports and modeling of key obesogenic behaviors, including breakfast, fruit and vegetable consumption, sugary beverage intake, feeding practices, portion sizes, active playtime, reduced screen-time, sleep and selection of child-care centers with characteristics that promote healthy behaviors.MethodsThus, the purpose of this study was to examine these factors via survey and focus groups among 139 parents of 2- to 5-year-old children. Standard content analysis procedures were used to identify trends and themes in the focus group data, and Analysis of Variance was used to test for differences between groups in the survey data.ResultsResults showed 80% of parents ate breakfast daily, consumed sugary beverages 2.7 ± 2.5SD days per week, and had at least two different vegetables and fruits an average of 5.2 ± 1.8SD and 4.6 ± 2.0SD days per week. Older parents and those with greater education drank significantly fewer sugary drinks. Parents played actively a mean 4.2 ± 2.2 hours/week with their preschoolers, who watched television a mean 2.4 ± 1.7 hours/day. Many parents reported having a bedtime routine for their preschooler and choosing childcare centers that replaced screen-time with active play and nutrition education. Common barriers to choosing healthful behaviors included lack of time; neighborhood safety; limited knowledge of portion size, cooking methods, and ways to prepare healthy foods or play active indoor games; the perceived cost of healthy options, and family members who were picky eaters. Supports for performing healthful behaviors included planning ahead, introducing new foods and behaviors often and in tandem with existing preferred foods and behaviors, and learning strategies from other parents.ConclusionsFuture education programs with preschool parents should emphasize supports and encourage parents to share helpful strategies with each other.

Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles) with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251) and content (n = 261) occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial.

To examine screentime behaviors and beliefs, barriers to limiting screentime, and methods for coping with barriers of parents of preschool children. Design, Setting and Participants: Parents of preschool children (2 to 5 years old) completed surveys (n¼133); a subset participated in focus group interviews (English-speakers¼16; Spanish-speakers¼14). Constant data comparison occurred concurrently with data collection to establish when data saturation was reached. Outcome Measures and Analysis: Three trained researchers independently conducted content analyses of data to identify themes and trends. Results: Parents reported their children spent 2.4AE1.7SD hours daily watching television, with no significant differences in this time occurring among parent education levels, language spoken, or parent age. Parents were divided on the importance of limiting screen time and unaware of recommendations for acceptable amounts. Parents reported they used television as a ''babysitter'' and to calm their children. Some felt children's television viewing needed to be monitored because TV is commercialized and can lead to ''unacceptable behavior,'' ''obesity,'' or ''bad habits'' as children imitate what they watch. Some parents believed that food/beverage advertisements could influence their children. Barriers to limiting television included lack of affordable alternate activities, convenience, inclement weather, parent fatigue, and desire to have time away from children to complete other activities. To overcome barriers to limiting screentime, parents found alternate activities for children, removed TVs from children's bedrooms, set daily routines/screentime limits, and set an example by not watching television themselves. Conclusions and Implications: Obesity prevention interventions should encourage parents to limit screentime and provide cost-effective alternative activities and convenient strategies for limiting children's screentime. Funding: USDA.

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Community family educators have the opportunity to incorporate childhood obesity prevention concepts in their programming with families of young children, but often lack formal health and nutrition education. The purpose of this feasibility study was to create an online training certificate program for community family educators and assess the program's effectiveness at improving participant's knowledge, attitudes, and intended and actual behaviors related to healthy lifestyles. Community family educators (n = 68) completed an online pretest, viewed 13 brief videos (8-15 min) focused on childhood obesity related topics and took mini-knowledge self-checks after each video followed by an online posttest. At posttest, paired t tests showed participants' childhood obesity prevention related knowledge (i.e., nutrition, physical activity, screen time and sleep) improved significantly (p < 0.001). Participants' attitudes toward parenting behaviors related to feeding practices, family meals, physical activity, screen time control and parent modeling significantly (p < 0.05) improved. Improvements also were seen in participants' intentions to promote obesity prevention behaviors (i.e., age appropriate portions sizes, adequate physically active, and parental role modeling). Furthermore, changes in personal health behaviors at posttest revealed participants had significantly (p < 0.05) greater dietary restraint, improvements in sleep quality, and reductions of use of electronic devices during meals and snacks. Overall, participants were very satisfied with the training program, felt comfortable with skills acquired, and enjoyed the program. Findings suggest this online training program is a feasible and effective method for improving community family educators' knowledge, attitudes, and intentions for obesity-prevention related parenting practices.