Obesity Prevention in Preschool Native‐American Children: A Pilot Study Using Home Visiting

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Abstract
To determine whether maternal participation in an obesity prevention plus parenting support (OPPS) intervention would reduce the prevalence of obesity in high-risk Native-American children when compared with a parenting support (PS)-only intervention. Forty-three mother/child pairs were recruited to participate. Mothers were 26.5 +/- 5 years old with a mean BMI of 29.9 +/- 3 kg/m(2). Children (23 males) were 22 +/- 8 months old with mean weight-for-height z (WHZ) scores of 0.73 +/- 1.4. Mothers were randomly assigned to a 16-week OPPS intervention or PS alone. The intervention was delivered one-on-one in homes by an indigenous peer educator. Baseline and week 16 assessments included weight and height (WHZ score and weight-for-height percentile for children), dietary intake (3-day food records), physical activity (measured by accelerometers), parental feeding style (Child Feeding Questionnaire), and maternal outcome expectations, self-efficacy, and intention to change diet and exercise behaviors. Changes in WHZ scores showed a trend toward significance, with WHZ scores decreasing in the PS condition and increasing among the OPPS group (-0.27 +/- 1.1 vs. 0.31 +/- 1.1, p = 0.06). Children in the OPPS condition also significantly decreased energy intake (-316 +/- 835 kcal/d vs. 197 +/- 608 kcal/d, p < 0.05). Scores on the restriction subscale of the Child Feeding Questionnaire decreased significantly in the OPPS condition (-0.22+/- 0.42 vs. 0.08+/- 0.63, p < 0.05), indicating that mothers in the OPPS group were engaging in less restrictive child feeding practices over time. A home-visiting program focused on changing lifestyle behaviors and improving parenting skills showed promise for obesity prevention in high-risk Native-American children.