A randomised controlled trial for overweight and obese parents to prevent childhood obesity - Early STOPP (STockholm Obesity Prevention Program)

Abstract

BackgroundOverweight and obesity have a dramatic negative impact on children's health not only during the childhood but also throughout the adult life. Preventing the development of obesity in children is therefore a world-wide health priority. There is an obvious urge for sustainable and evidenced-based interventions that are suitable for families with young children, especially for families with overweight or obese parents. We have developed a prevention program, Early STOPP, combating multiple obesity-promoting behaviors such unbalanced diet, physical inactivity and disturbed sleeping patterns. We also aim to evaluate the effectiveness of the early childhood obesity prevention in a well-characterized population of overweight or obese parents. This protocol outlines methods for the recruitment phase of the study.Design and methodsThis randomized controlled trial (RCT) targets overweight and/or obese parents with infants, recruited from the Child Health Care Centers (CHCC) within the Stockholm area. The intervention starts when infants are one year of age and continues until they are six and is regularly delivered by a trained coach (dietitian, physiotherapist or a nurse). The key aspects of Early STOPP family intervention are based on Swedish recommendations for CHCC, which include advices on healthy food choices and eating patterns, increasing physical activity/reducing sedentary behavior and regulating sleeping patterns.DiscussionThe Early STOPP trial design addresses weaknesses of previous research by recruiting from a well-characterized population, defining a feasible, theory-based intervention and assessing multiple measurements to validate and interpret the program effectiveness. The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge, this longitudinal RCT is the first attempt to demonstrate whether an early, long-term, targeted health promotion program focusing on healthy eating, physical activity/reduced sedentary behaviors and normalizing sleeping patterns could be effective. If proven so, Early STOPP may protect children from the development of overweight and obesity.Trial registrationThe protocol for this study is registered with the clinical trials registry clinicaltrials.gov, ID: ES-2010)

Population Approaches to Improve Diet, Physical Activity, and Smoking Habits

“…Additional ongoing cluster RCTs will provide important additional evidence on the efficacy of overall school-based programs to improve physical activity and reduce adiposity. 262,263 …”

The SI! Program for Cardiovascular Health Promotion in Early Childhood

“…Most published scientific data on school-based interventions relates to the prevention of childhood obesity and is focused on 2 traditional components related to energy balance: diet and/or physical activity; few studies have included other behavioral components related to cardiovascular health, such as prosocial behaviors (12,13). Incorporating the promotion of positive social interactions through improved management of emotions has been proposed as a way of preventing the initiation of addictions, such as smoking or alcohol consumption (2,14,15).…”

Development of sleep patterns in children with obese and normal‐weight parents

“…A total of 236 children and families in the Stockholm area were recruited to the project between 2010 and 2013. The study design and recruitment have been previously described in detail . Briefly, families were recruited randomly when parents visited a local child health‐care centre (CHC) for their child's 8‐month check‐up.…”

“…Full details of the intervention programme have been described in the study protocol . Briefly, the multifaceted intervention, consisting of education and individual target coaching, was aimed at increasing parents' knowledge and skills to promote parenting behaviour regarding child diet, sleep and physical activity.…”

“…The Early Stockholm Obesity Prevention Project (Early STOPP) is a randomised controlled obesity prevention targeting pre‐schoolers with parents with overweight or obesity (at high obesity risk) . Children with parents of normal weight are also included as a low obesity risk group.…”