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. 2018 Jul 26:4:129.
doi: 10.1186/s40814-018-0322-4. eCollection 2018.

Feasibility and outcomes of an out-of-school and home-based obesity prevention pilot study for rural children on an American Indian reservation

Blakely Brown  1 , Kari Jo Harris  2 , Daniel Heil  3 , Michael Tryon  4 , Aric Cooksley  5 , Erin Semmens  1 , James Davis  6 , Krupa Gandhi  7
Affiliations

Feasibility and outcomes of an out-of-school and home-based obesity prevention pilot study for rural children on an American Indian reservation

Blakely Brown et al. Pilot Feasibility Stud. .

Abstract

Background: Children living in rural areas are at higher risk for obesity compared to urban children, and Native American (NA) children have the highest prevalence of overweight/obesity for all races combined. Out-of-school programs (OOSPs) are a promising setting to improve children's health. Parents are important in supporting their child's obesity-related behaviors, yet it remains unclear what combination and dose of parent engagement strategies is feasible and optimal. This study's primary objective was to assess the feasibility of an OOSP and home-based obesity prevention intervention for rural NA and non-NA children.

Methods: This was an 11-week, two group, randomized feasibility study. Participants were children and their parents at one OOSP on a rural American Indian reservation. Children, ages 6-9, were randomized to receive the Generations Health (GH) intervention or comparison condition. The GH group received daily activities focused on physical activity (PA), nutrition, sleep, and reducing TV/screen time, and frequently engaged parents. The comparison group received usual OOSP activities. To assess intervention feasibility, we measured recruitment and participation rates and program satisfaction. We assessed pre- to posttest changes in body composition, PA and sleep patterns, dietary intake and Healthy Eating Index-2010 (HEI-2010) scores, TV/screen time, and nutrition knowledge. We report recruitment and participation rates as percentages and participants' program satisfaction as means. Two-tailed paired t tests and 95% confidence intervals were used to detect changes in behavioral and health outcome variables.

Results: Forty-six children met age eligibility criteria; following screening, 52% (24/46) met the inclusion criteria and 96% (23/24) were randomized to the study. Overall, 91% of the children participated in the intervention and 100% participated in at least some of the posttest assessments. Parents reported high program satisfaction (mean rating of 4, on a 1-5 scale). Our outcome measure for child adiposity, zBMI, was reduced by 0.15 in the GH group, but increased by 0.13 in the comparison condition. Meaningful changes were evident for total kilocalories, HEI-2010 scores, PA, TV/screen time, and nutrition knowledge.

Conclusions: High recruitment, participation and program satisfaction and positive health and behavioral outcomes at 11 weeks provide encouraging indications of the feasibility and potential effectiveness of the intervention.

Trial registration: ISRCTN24274245.

Keywords: Child health behavior; Intervention feasibility; Native American; Obesity prevention; Out-of-school settings; Parents; Rural.

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Conflict of interest statement

All child and parent participants provided informed consent to participate in the study. Approval to conduct the study was obtained from the institutional review board at Salish-Kootenai College, Pablo Montana, USA; study protocol #2014_19.All participants providing informed consent agreed to a confidentiality clause in the consent form that stated if the results of this study were written in a scientific journal or presented at a scientific meeting, neither the parent’s name nor the child’s name would be used.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
CONSORT 2010 flow diagram for the Generations Health Feasibility study
See this image and copyright information in PMC

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