The ENCOURAGE healthy families study: A comparative effectiveness trial to reduce risk for type 2 diabetes in mothers and children

Hannon, Tamara S; Saha, Chandan; Carroll, Aaron E.; Palmer, Kelly; Phillips, Erin O’Kelly; Marrero, David G.

doi:10.1111/pedi.12692

Cited by 10 publications

(30 citation statements)

References 33 publications

(51 reference statements)

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“…Several of our outcome measures were self-reported, raising the potential for social desirability of response. Participant retention was a challenge, reaching 25% attrition at 12 weeks; while disappointing, this was consistent with similar studies in the literature ( Baranowski et al, 2003 ; Foster et al, 2012 ; Gentile et al, 2009 ; Hannon et al, 2018 ; Sanigorski et al, 2008 ).…”

Section: Discussionsupporting

confidence: 88%

“…Overall, there remains a paucity of T2D prevention studies outside of school settings, particularly ones which engage parents ( Baranowski et al, 2002 ; Hingle et al, 2010 ; O'Connor et al, 2009 ). To our knowledge, few youth-focused T2D prevention studies directly involving family members and led by trained paraprofessionals have been conducted, and those have not been tested at scale ( Foster et al, 2012 ; Hannon et al, 2018 ; Mantilla et al, 2017 ) or were tailored to serve very specific racial groups (i.e., African American( Burnet et al, 2011 ) and Native American ( Chambers et al, 2018 ; Sauder et al, 2018 )).…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study

Hingle

Turner

Going

et al. 2019

Preventive Medicine Reports

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Efficacious lifestyle modification programs for children at risk of type 2 diabetes (T2D) have not been well established outside of clinical settings. In this study, the feasibility of a family-focused, YMCA-based prevention program for children at risk of T2D was evaluated between September 2015 and July 2016 in Tucson, Arizona. A 12-week YMCA-led lifestyle intervention was adapted for 9–12-year-old children and their families to encourage healthy eating, physical activity, and supportive home environments. Two YMCA locations were randomized to offer either a face-to-face lifestyle coach-led intervention or an alternating face-to-face and digitally-delivered intervention. Program feasibility and preliminary effects on child anthropometric and behavioral outcomes were assessed at baseline and post-intervention. Changes were assessed using linear regression combining delivery formats, with adjustment for clustering of participants within site/format. Forty-eight children (10.9 ± 1.2 years old; 45% female; 40% Hispanic; 43% White; 87% obese) and their parents enrolled, and 36 (75%) completed 12-week measures. Weekly program attendance averaged 61%. Participants and coaches highly rated program content and engagement strategies. Statistically significant changes in child BMI-z score (−0.05, p = 0.03) and family food and physical activity environment (+5.5% family nutrition and physical activity score, p = 0.01) were observed. A YMCA-led family-focused T2D intervention was feasible for the YMCA and participants and effects on child weight, behavior, and the home environment warranted further investigation.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study

Hingle

Turner

Going

et al. 2019

Preventive Medicine Reports

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“…Family-level clustering of these factors, combined with evidence to support parental engagement as an essential component of childhood obesity program effectiveness, 12 have informed the development of effective family-oriented obesity and diabetes prevention interventions for children. [13][14][15][16] Rarely, however, have programs initially designed for adults been considered a means to reach high-risk children, either through spillover effects of adult-oriented programming or familyoriented adaptations that intentionally address child health behaviors. There is, however, emerging and encouraging evidence to suggest that adaptations of the National DPP intervention that also address child health behaviors may be effective in improving children's weight trajectories.…”

Section: Discussionmentioning

confidence: 99%

“…There is, however, emerging and encouraging evidence to suggest that adaptations of the National DPP intervention that also address child health behaviors may be effective in improving children's weight trajectories. 15 In this analysis, we were able to explore the relationship between only 1 parent and 1 child who were selected as sample household members. We do not have similar information for other parents or other children, in particular younger children, in the household.…”

Section: Discussionmentioning

confidence: 99%

Lifestyle Intervention Programs for Adults at High-Risk for Type 2 Diabetes: A Platform to Reach High-Risk Children?

et al. 2019

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Introduction: Children of adults eligible for the National Diabetes Prevention Program (DPP) lifestyle intervention may themselves be high risk for type 2 diabetes development, and high-risk children may be reached through programs that target high-risk adults. To understand the potential multigenerational impact of family-oriented diabetes prevention programming, we explored the correlation between parental eligibility for the National DPP program and child weight status by using nationally representative data. Methods: We analyzed data from the National Health Interview Survey from 2016 and 2017, focusing on children ages 12 through 17 years of age for whom body mass index (BMI) data were available and who could be linked to 1 sample parent. We explored the association between parent and child weight status and parental DPP eligibility and child weight status using 2 analyses. Results: Our final sample consisted of 3,905 (unweighted) children, linked to either a mother or father. A total of 25.8% of children were overweight or obese; 68.1% of linked parents were overweight or obese, and child and parent weight status were correlated (Pearson's 2 , P < .001). A total of 9.5% of parents were likely eligible to participate in the National DPP. Parental program eligibility was positively correlated with child overweight/obese status (2 , P < .001); over one-third of children with eligible parents were themselves overweight/obese. Discussion: In this nationally representative sample, parental BMI and child BMI categories were positively correlated, as was parental eligibility for diabetes prevention programming and child BMI. This highlights the potential of leveraging the national platform for adult diabetes prevention to reach high-risk children through family-oriented programming.

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“…This study relied on self-report of participants. Subsequent studies will include objective measurements of obesity-related outcomes including blood pressure, obesity, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, as many contribute to not only obesity but other resulting comorbidities including diabetes and cardiovascular disease (Hannon, Saha, Carroll, Palmer, O'Kelly Phillips, & Marrero, 2018). An additional limitation was lack of a control group to ensure preliminary changes were due to the intervention, instead of extraneous factors.…”

Section: Limitationsmentioning

confidence: 99%

Utilization of a Community-based Participatory Approach to Design and Implement a Peer-led Parenting Pilot Intervention to Influence Child Nutritional and Physical Activity Behaviors

Akintobi

Ede

Wrenn

et al. 2020

JGPHA

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Parents and primary child guardians within the household play critical roles in shaping their children's nutritional and physical activity behaviors, which are among the individual-level determinants of childhood obesity and other chronic conditions. There are well-established correlations between race, socioeconomic status and the risk for obesity calling for both contextually-and individual-centered interventions that are community-driven. The Using Quality Parenting (UQP) pilot intervention was a peer-led, parenting education intervention developed in collaboration with community residents in Atlanta, Georgia to influence child nutritional and physical activity behaviors in African American low socioeconomic status communities. A community-based participatory research (CBPR) framework was used to conduct a mixed-methods needs assessment designed to the UQP curriculum. The UQP program targeted parents of children ages 6-14. The overarching aim was to increase quality parenting and address community identified child obesity disparities and inequities in early and middle childhood. The topics pertaining to parenting to children's health/well-being addressed by the UQP included nutrition, physical activity, socio-emotional development, positive parenting, coping skills, child advocacy, and community development. Analyses were conducted using PSAW 18 statistical software. Descriptive statistics, including frequencies, means, standard deviations, and ranges for the individual survey items were conducted. A t-test was performed comparing pre-and post-program participation. A repeated measure analysis of variance was conducted on the items that demonstrated a significant t-test. The analytic sample was composed of 46 African American parents, with over 50% of the sample earning an annual household income of $25,000 or less. Participating parents reported significantly higher levels of water consumption for their children post-program in comparison to pre-test reports (p = .010). Additionally, based on t-test analyses, parents reported that their children consumed significantly higher levels of proteins, grains, fruits and vegetables at each meal, post-program (p=0.03). These findings highlight the potential efficacy of community-informed, parent-led interventions in improving health disparities and related outcomes for children.

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The ENCOURAGE healthy families study: A comparative effectiveness trial to reduce risk for type 2 diabetes in mothers and children

Abstract: ENCOURAGE was beneficial for reducing BMI percentile in participating children.

Cited by 10 publications

References 33 publications

Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study

Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study

Lifestyle Intervention Programs for Adults at High-Risk for Type 2 Diabetes: A Platform to Reach High-Risk Children?

Utilization of a Community-based Participatory Approach to Design and Implement a Peer-led Parenting Pilot Intervention to Influence Child Nutritional and Physical Activity Behaviors

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