Involving Parents in Promoting Healthy Energy Balance-Related Behaviors in Preschoolers: A Mixed Methods Impact and Process Evaluation of SuperFIT

Abstract

Parental involvement is an essential component of obesity prevention interventions for children. The present study provides a process and impact evaluation of the family component of SuperFIT. SuperFIT is a comprehensive, integrated intervention approach aiming to improve energy balance-related behaviors (EBRBs) of young children (2–4 years). A mixed methods design combined in-depth interviews with parents (n = 15) and implementers (n = 3) with questionnaire data on nutritional and physical activity-related parenting practices (CFPQ and PPAPP), the physical home environment (EPAO_SR) (n = 41), and intervention appreciation (n = 19). Results were structured using the concepts of reach, adoption, implementation, and perceived impact. Findings indicated that the families reached were mostly those that were already interested in the topic. Participants of the intervention appreciated the information received and the on-the-spot guidance on their child’s behavior. Having fun was considered a success factor within the intervention. Parents expressed the additional need for peer-to-peer discussion. SuperFIT increased awareness and understanding of parents’ own behavior. Parents made no changes in daily life routines or the physical home environment. Translating knowledge and learned strategies into behavior at home has yet to be achieved. To optimize impact, intervention developers should find the right balance between accessibility, content, and intensity of interventions for parents.

The Importance of Parents for Childhood and Adolescent Obesity Prevention: Should We Pay More Attention to Automatic Processes and Parental Stress?

“…However, it is rather difficult to reach and motivate these groups for such interventions. This has also been found by Harms and colleagues [8], investigating the process and impact evaluation of the family component of SuperFIT, an integrated intervention approach aiming to improve energy balance-related behaviours of young children aged 2-4 years. SuperFIT includes some important suggestions for intervention programs focusing on parents, including building attractive elements in the intervention, such as having fun and the need for peer-to-peer parent discussion, and integrating programs within existing activities, so that well-known practical barriers are avoided [8].…”

Adoption, implementation, and sustainability of early childhood feeding, nutrition and active play interventions in real-world settings: a systematic review

“…One paper was a hybrid effectiveness-implementation trial [ 44 ]. Four of the eleven studies were conducted in the United States [ 34 , 37 , 38 , 44 ], two in Australia [ 40 , 41 ], two in Bangladesh [ 39 , 43 ], one in the Netherlands [ 36 ], one in Malawi [ 35 ] and one in Ethiopia [ 42 ]. The studies were conducted in a range of settings including five in community [ 35 , 39 , 41 – 43 ], four in early care and education [ 36 , 38 , 40 , 44 ], one in a Women, Infants, and Children (WIC)-clinic in a community environment [ 34 ] and one in local parks and recreation centres [ 37 ].…”

“…Mangochi (rural) Blantyre (urban) Medical Research Council (MRC) Framework for complex interventions Evaluation frameworks Luecking 2021 [ 37 ] USA Mixed methods Convenience sample of 92 early care and education centres ( n = 48 intervention group, n = 44 delayed control group). Participants included ( n = 189 providers, n = 446 parents) 3-4 years Early care and education centres Fidelity index Process models Sarma 2021 [ 42 ] Bangladesh Mixed methods Caregivers of children 6-59 months, community health workers, and BRAC staff members 6-59 months 164 sub-districts and 6 urban slums in Bangladesh Program Impact Pathway (PIP) Implementation theories (in planning intervention evaluation) Heerman 2018 [ 36 ] USA Mixed methods 26 parent-child (3-5 years) pairs 3-5 years 3 local parks and recreation centres RE-AIM Evaluation frameworks Harms 2021 [ 35 ] Netherlands Mixed methods 427 children (2-4 years) from 12 intervention pre-schools. In-depth parent interviews = 15, In-depth implementers interviews = 3, Questionnaire: physical home environment = 41, Questionnaire: intervention appreciatio n = 19 2-4 years SuperFIT Family component: home environment.…”

“…Five TMFs were identified namely, the Program Impact Pathway (PIP) [ 43 ], Medical Research Council (MRC) Framework, Yamey Framework, and The integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) [ 41 ]. The most commonly identified TMF was RE-AIM [ 45 ] (Reach, Effectiveness, Adoption, Implementation, Maintenance) used across four different studies [ 36 , 37 , 40 , 44 ]. Two studies used models created by the study authors [ 34 , 39 ] and one study used a fidelity index [ 38 ].…”

Applying an ecosystem approach to explore modifiable factors related to the risk for low motor competence in young children

“…Physical activity parenting practices (PAPPs) were measured using a questionnaire comprising 27 statements on how often parents used a certain practice 19 . A Dutch translation was applied based on pre-school PAPPs, that were contextually transferred from a childcare context to the home environment as applied by Harms 20 . Each statement was measured using a 5-point Likert scale (1=never through 5=always).…”