A Pilot Study of Parent Mentors for Early Childhood Obesity

Abstract

Objective. To assess the feasibility of a parent mentor model of intervention for early childhood obesity using positive deviance-based methods to inform the intervention. Methods. In this pilot, randomized clinical trial, parent-child dyads (age: 2–5) with children whose body mass index (BMI) was ≥95th percentile were randomized to parent mentor intervention or community health worker comparison. The child's height and weight were measured at baseline, after the six-month intervention, and six months after the intervention. Feasibility outcomes were recruitment, participation, and retention. The primary clinical outcome was BMI z-score change. Results. Sixty participants were enrolled, and forty-eight completed the six-month intervention. At baseline, the BMI z-score in the parent mentor group was 2.63 (SD = 0.65) and in the community health worker group it was 2.61 (SD = 0.89). For change in BMI z-score over time, there was no difference by randomization group at the end of the intervention: −0.02 (95% CI: −0.26, 0.22). At the end of the intervention, the BMI z-score for the parent mentor group was 2.48 (SD = 0.58) and for the community health worker group it was 2.45 (SD = 0.91), both reduced from baseline, p < 0.001. Conclusion. The model of a parent mentor clinical trial is feasible, and both randomized groups experienced small, sustained effects on adiposity in an obese, Hispanic population.

Capacity‐oriented approaches to developing childhood obesity interventions: a systematic review

“…The positive deviance‐based interventions showed no difference from their comparison in adiposity outcomes . As the comparison groups also received an intervention of similar intensity in both studies, it is difficult to ascertain these interventions’ true efficacy.…”

“…There were two studies with published results using positive deviance to inform their intervention (Foster 2016 and Taveras 2017 ). Both studies were randomized clinical trials (RCTs) with two arms, although Taveras et al .…”

“…In Foster et al . 2016, five strategies that were identified as using a positive deviance approach were incorporated into the intervention arm as well: (i) dealing with behavior problems without using food; (ii) identifying internal motivators for healthy habits; (iii) organizational strategies for feeding; (iv) accurate perceptions of weight and (v) effective snacking strategies .…”

“…These focus groups identified five themes that were incorporated into the intervention arm: (i) making changes as a family; (ii) setting rules and limits around snacking and screen time; (iii) being involved in decisionmaking with their provider; (iv) using immediate outcomes to help motivate and (v) effectively using community resources. In Foster et al 2016, five strategies that were identified as using a positive deviance approach were incorporated into the intervention arm as well: (i) dealing with behavior problems without using food; (ii) identifying internal motivators for healthy habits; (iii) organizational strategies for feeding; (iv) accurate perceptions of weight and (v) effective snacking strategies (18).…”

Factors Associated with Successful Mentoring of Parents Addressing Childhood Obesity: A Mixed Methods Approach

“…The overall study was designed as a randomized trial targeting Hispanic, obese, 2–5-year-old children and their parents who were enrolled in a Head Start program (a federally-funded early childhood education program for low-income families) in the lower Rio Grande Valley in south Texas [11, 12]. There were 60 parent-child dyads enrolled in the study, and they were randomized 1 : 1 to receive teaching from either a parent mentor or a community health worker using a standardized curriculum [13].…”