Randomized Controlled Trial to study the effectiveness of Lifestyle Triple P: a childhood obesity intervention aimed at parents of overweight children

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1 Randomized Controlled Trial to study the effectiveness of Lifestyle Triple P: a childhood obesity intervention aimed at parents of overweight children S.M.P.L. Gerards 1, P.C. Dagnelie, M.W.J. Jansen, O.H.M. Van der Goot, N.K. De Vries, M.R. Sanders and S.P.J. Kremers 1 Department of Health Promotion Department

2 Child overweight & obesity

3 Consequences overweight and obesity Physical consequences Cardiovascular diseases Diabetes type II Social consequences Tracking

4 Why start with early prevention? Overweight at young age predicts excessive weight gain in the future Children have a relative short history of unhealthy habits Children can reduce their BMI without losing weight

5 Role of parents Parents are responsibile for children s nutrition and physicical activity patterns Parenting practices vs parenting styles Interventions aimed at changing parenting styles are effective in the prevention and management of childhood obesity (Gerards et al., 2011)

6 Lifestyle Triple P intervention RCT (N = 101) in Australia Results: Reduction BMI z-score Reduction children s weight related problem behaviour Increase parental confidence towards managing children s weight related problem behaviour Reduction ineffective parenting West et al. 2010

7 Lifestyle Triple P in NL > GO4fit

8 GO4fit study Baseline measurements Randomization Control condition 6 LifestyleTripleP groups 14-week measurements 12-month measurements

9 Outcome measures Body Mass Index (z-scores) Waist circumference Biceps and triceps skinfolds Physical activity level Questionnaire parents Parenting (practices, style and self-efficacy) Lifestyle child Personality characteristics child

10 Control condition Brochures on positive parenting, healthy nutrition and physical activity Tailored feedback via internet

11 Objectives intervention Improving children s dietary intake, activity levels, and weight status Increasing parenting skills and confidence Reducing parents use inconsistent parenting practices Improving parents communication about health and nutrition Reducing parenting stress

12 Structure (1) 8 group sessions 2 individual telephone sessions 1 group session 2 individual telephone sessions 1 final group session Department Background of Methods Health Promotion Preliminary results Discussion

13 Structure (2) Location: buildings Pubic Health Services (GGD) in Geleen, Heerlen and Maastricht (southern part of the Netherlands) 3 trainers with Lifestyle Triple P accreditation (2 nurses, 1 PhD student) Materials: powerpoint, DVD, workbook, recipe booklet en active games booklet

14 Lifestyle Triple P strategies

15 Recruitment participants Youth Health Care Mass media Personal letters Department Background of Methods Health Promotion Preliminary results Discussion

16 Current number of respondents Total: 68 respondents 33 control 35 intervention (5 groups)

17 Baseline characteristics children Total (n=70) Mean (sd) N (%) Age 7.3 (1.5) Male 32 (47%) BMI z-score 1.86 (0.8) Weight status N % Healthy weight 9 13% Overweight 15 22% Obesity 44 65%

18 Baseline characteristics siblings Total (n=18) Mean (sd) N (%) Age 7.4 (2.2) Male 7 (39%) BMI z-score 0.96 (0.8) Weight status N % Healthy weight 8 44% Overweight 6 33% Obesity 4 22%

19 Baseline characteristics family N = 34 Fathers Mothers Educational level Low Medium High 1 (3%) 18 (53%) 12 (35%) 6 (17%) 19 (56%) 9 (26%) Employment status 26 working (76%) 24 working (71%) Mean hours of working Country of birth: the Netherlands (83%) 29 (85%)

20 Baseline characteristics parents Mothers (n= 60) Fathers (n= 37) BMI 28.8 (5.8) 29.9 (5.4) Waist circumference 93.4 (15.1) (14.8) Healthy weight 20 (33%) 6 (16%) Overweight 15 (25%) 14 (38%) Obese 24 (40%) 17 (43%)

21 Change BMI children Total (n=31) BMI z-score baseline BMI z-score posttest Intervention N=16 Control n= (0.64) 1.90 (0.72) 1.48 (0.69) 1.84 (0.71) Change

22 Change scores BMI parents Intervention Control Mothers N=14 N=13 BMI baseline (6.5) (5.2) BMI posttest (6.9) (5.6) Change Fathers N=8 N=5 BMI baseline (4.5) (7.5) BMI posttest (4.9) (7.7) Change = 1,5 kg

23 Discussion (1) Evaluation group sessions (grade 1-10): 8.1 Positive feedback from families Focus on both parenting styles and practices

24 Discussion (2) Strengths Design Long-term follow-up Outcome measures Challenges Recruitment issues Implementation issues Final results expected end 2013

25 Thanks for your attention! Questions? Department

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