The Strong Families Trial: Randomised controlled trial of a family strengthening program to prevent unhealthy weight gain among 5- to 11-year old children from at risk families.
Western Sydney University
800 participants
Feb 23, 2022
Interventional
Conditions
Summary
Childhood obesity is a serious public health problem which tracks into adulthood. While some community-based prevention efforts have been shown to be successful, this is not the case for disadvantaged culturally diverse populations. Family dysfunction contributes to unhealthy eating and physical activity (PA) patterns among children and is common in disadvantaged populations. Family-focused programs that include positive support are effective in improving family dynamics and may be important in preventing childhood obesity in these populations. We will test whether a 6-week behavioural parenting and lifestyle (BPL) intervention (+2 boosters) for parents and carers of 5-11 year-old children is effective, sustainable and cost-effective in improving children’s anthropometric outcomes and family functioning. Measurements at baseline, end of intervention and 12 months post-intervention will assess changes in children’s weight, PA, and eating behaviours, as well as in family functioning and parent knowledge and behaviour. This family-centred intervention has the potential to reduce obesity through improved family functioning in relation to eating and physical activity patterns in children in disadvantaged and multi-ethnic populations. Cost-effective programs are urgently needed to reduce childhood obesity and its inequalities among ‘at-risk’ populations.
Eligibility
Inclusion Criteria6
- Children aged between 5-11 years.
- Families who live in the Greater Western Suburbs of Sydney.
- Parents/carers who live in the same household as their child.
- Are either Australian born or migrants (predominantly speaking Arabic, Hindi and Punjabi).
- Live in socio-economically disadvantaged areas (< 1000 Index of socio-economic disadvantage).
- For households with two or more eligible children, we will include the child who had the most recent birthday.
Exclusion Criteria1
- Self-reported mental or major physical illness or intellectual disability among parents/carers and/or their eligible offspring which would hamper effective participation and/or lead to inability to commit to the group process
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Interventions
The face-to-face behavioural parenting and lifestyle (BPL) intervention will comprise of 6 x 90 min weekly group sessions (plus 2 x 45 min boosters at 3 months follow-up), incorporating the parenting and healthy lifestyle components trialled in our pilot. The 2 booster sessions will occur 3 months after completing the 6 intervention sessions. The Booster sessions are a refresher of the Health Lifestyles modules (Booster Session 1) and the Parenting modules (Booster Session 2). The sessions will revise and solidify an understanding of all key messages and provide an opportunity for facilitated group discussions among participants. The sessions include a 20-minute presentation providing a summary of the key messages, along with a 25-minute Q&A to address some of the participants’ experiences and reflections in implementing the learnings. Based on our pilot data, sessions will be delivered using audio-visual presentations, facilitator-led small group discussions, mini case studies and practical activities catering for parents’ range of literacy. These delivery modes emphasise that socially situated learning is key to effective delivery of health promotion messages. Groups of 6-8 parents/carers will participate in face-to-face sessions, with experienced bilingual group facilitators. Participants will receive take-home materials for secondary carers. Given that 37–56% of the population in our target areas are migrants speaking mainly Arabic, Hindi and Punjabi, the BPL modules will be delivered in each of these languages in addition to English, thus addressing language barriers, cultural dimensions and beliefs related to obesity and its risk factors. Homogeneity is neither possible nor desirable; external validity is more important. Below is an outline of the weekly content: Module 1: Building Healthy Habits - Building strong and healthy families, choosing water as a drink, getting active each day, switching off screens, getting enough sleep & healthy sleep habits. Module 2: Healthy Eating Every Day - Understanding healthy eating, developing healthy eating habits, the importance of breakfast, healthy lunch & snack habits. Module 3: Making Healthy Choices - Smart food swaps, healthier cooking methods, healthier choices away from home, understanding food labels, smart supermarket choices. Module 4: Building Strong Families - Becoming a parent, the essential components of a strong family, understanding childhood development. Module 5: Praise, Rewards, Rules & Consequences - Promoting positive behaviour, setting family rules, responding to children's behaviour, using consequences effectively. Module 6: Improving Communication & Managing Emotions - Improving family communication, the importance of understanding emotions, helping children to deal with big emotions, reducing stress, sharing the load. Booster A: Healthy Lifestyles Booster B: Parenting The BPL sessions will be facilitated by counsellors, psychologists or social workers for the parenting component and dietitians or nutritionists for the lifestyle component.
Locations(1)
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ACTRN12619001019190