Research Research and Practice Innovations| Volume 114, ISSUE 6, P945-950, June 2014

Download started.


Practice-Based Evidence of Effectiveness in an Integrated Nutrition and Parenting Education Intervention for Low-Income Parents

Published:December 04, 2013DOI:


      Research identifying associations between parental behaviors and children's food and activity choices and weight suggests that the integration of parenting and nutrition education holds promise for promoting healthful eating and activity in families. However, translational research leading to sustainable interventions lags behind. Development and testing of interventions within actual program contexts is needed to facilitate translation to full-scale implementation. Therefore, the goal of this pilot study was to develop and test an integrated nutrition and parenting education intervention for low-income families within the Expanded Food and Nutrition Education Program in New York State. During a 21-month period, low-income parents of 3- to 11-year-olds were recruited through usual programmatic channels by nutrition program staff to participate in a series of eight workshops delivered to small groups. A validated self-administered questionnaire was used to assess behavior change outcomes among 210 parents who completed the program. Mean scores improved significantly for most behaviors, including adult fruit and vegetable intake; adult and child low-fat dairy and soda intake; and child fast-food intake, activity, and screen time (P<0.001). Many parents reported eating together with children at program entry, leaving little room to improve, but about 20% reported at least a 1-point improvement (on a 5-point scale). The most frequent change was reducing how often children ate fast food and was reported by >50% of parents. Design and testing through practice-based research can facilitate development of interventions that are both feasible and likely to improve eating and activity behaviors among low-income families.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Clark H.R.
        • Goyder E.
        • Bissell P.
        • Blank L.
        • Peters J.
        How do parents' child-feeding behaviours influence child weight? Implications for childhood obesity policy.
        J Public Health. 2007; 29: 132-141
        • Rhee K.
        Childhood overweight and the relationship between parent behaviors, parenting style, and family functioning.
        Ann Am Acad Pol Soc Sci. 2008; 615: 11-37
        • Ventura A.
        • Birch L.
        Does parenting affect children's eating and weight status?.
        Int J Behav Nutr Phys Act. 2008; 5: 15
        • Birkett D.
        • Johnson D.
        • Thompson J.R.
        • Oberg D.
        Reaching low-income families: Focus group results provide direction for a behavioral approach to WIC services.
        J Am Diet Assoc. 2004; 104: 1277-1280
        • Halpern R.
        Early childhood intervention for low-income children and families.
        in: Shonkoff J. Meisels S. Handbook of Early Childhood Intervention. 2nd ed. Cambridge University Press, New York, NY2000: 361-386
        • Kumanyika S.
        • Grier S.
        Targeting interventions for ethnic minority and low-income populations.
        Future Child. 2006; 16: 187-207
        • Green L.W.
        • Glasgow R.E.
        Evaluating the relevance, generalization, and applicability of research: Issues in external validation and translation methodology.
        Eval Health Prof. 2006; 29: 126-153
      1. Food and Nutrition Education in Communities. Collaboration for Health, Activity, and Nutrition in Children's Environments (CHANCE). 2011. Accessed December 12, 2012.

      2. US Department of Agriculture. Expanded Food and Nutrition Education Program (EFNEP). Accessed December 12, 2012.

        • Davison K.K.
        • Birch L.L.
        Childhood overweight: A contextual model and recommendations for future research.
        Obes Rev. 2001; 2: 159-171
        • Vella J.
        • Uccellani V.
        Learning to Listen to Mothers: A Trainers' Manual to Strengthen Communication Skills for Nutrition and Growth Promotion.
        Academy for Educational Development, Washington, DC1993
        • Cullen K.W.
        • Baranowski T.
        • Smith S.P.
        Using goal setting as a strategy for dietary behavior change.
        J Am Diet Assoc. 2001; 101: 562-566
        • AbuSabha R.
        • Achterberg C.
        Review of self-efficacy and locus of control for nutrition- and health-related behavior.
        J Am Diet Assoc. 1997; 97: 1122-1132
        • Lent M.
        • Hill T.F.
        • Dollahite J.S.
        • Wolfe W.S.
        • Dickin K.L.
        Healthy Children, Healthy Families: Parents Making a Difference! A curriculum integrating key nutrition, physical activity, and parenting practices to help prevent childhood obesity.
        J Nutr Educ Behav. 2012; 44: 90-92
        • Malik V.S.
        • Willett W.C.
        • Hu F.B.
        Nutritively sweetened beverages and obesity.
        J Am Med Assoc. 2009; 301: 2210
        • Whitaker R.C.
        A Review of Household Behaviors for Preventing Obesity in Children.
        Mathematica Policy Research, Inc, Princeton, NJ2004: 6059-6200
        • Woodward-Lopez G.
        • Ritchie L.D.
        • Gerstein D.E.
        • Crawford P.B.
        Obesity: Dietary and Developmental Influences.
        CRC Press, Boca Raton, FL2006
        • Institute of Medicine
        Preventing Childhood Obesity: Health in the Balance.
        National Academies Press, Washington, DC2004
        • Hughes S.O.
        • Power T.G.
        • Orlet Fisher J.
        • Mueller S.
        • Nicklas T.A.
        Revisiting a neglected construct: Parenting styles in a child-feeding context.
        Appetite. 2005; 44: 83-92
        • Patrick H.
        • Nicklas T.A.
        • Hughes S.O.
        • Morales M.
        The benefits of authoritative feeding style: Caregiver feeding styles and children's food consumption patterns.
        Appetite. 2005; 44: 243-249
        • Dickin K.L.
        • Lent M.
        • Lu A.H.
        • Sequeira J.
        • Dollahite J.S.
        Developing a measure of behavior change in a program to help low-income parents prevent unhealthful weight gain in children.
        J Nutr Educ Behav. 2012; 44: 12-21
        • Akers J.D.
        • Estabrooks P.A.
        • Davy B.M.
        Translational research: Bridging the gap between long-term weight loss maintenance research and practice.
        J Am Diet Assoc. 2010; 110: 1511-1522.e1513
        • Rohs F.R.
        • Langone C.A.
        • Coleman R.K.
        Response shift bias: A problem in evaluating nutrition training using self-report measures.
        J Nutr Educ. 2001; 33: 165-170


      K. L. Dickin is a research scientist, Division of Nutritional Sciences, Cornell University, Ithaca, NY.


      T. F. Hill is an extension associate, Division of Nutritional Sciences, Cornell University, Ithaca, NY.


      J. S. Dollahite is a professor, Division of Nutritional Sciences, Cornell University, Ithaca, NY.