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Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial

      Abstract

      Background

      Research has demonstrated a significant positive association between frequent family meals and children’s dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial.

      Objective

      To describe family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment Plus program, the first rigorously tested family meals intervention targeting childhood obesity prevention.

      Design

      Randomized controlled trial. Baseline, postintervention (12 months, 93% retention), and follow-up (21 months, 89% retention) data (surveys and dietary recalls) were collected.

      Participants/setting

      Children aged 8 to 12 years (N=160) and their parents were randomized to intervention (n=81) or control (n=79) groups.

      Intervention

      The intervention included five parent goal-setting calls and 10 monthly sessions delivered to families in community settings that focused on experiential nutrition activities and education, meal planning, cooking skill development, and reducing screen time.

      Main outcome measures

      Family home food environment outcomes and nutrition-related child and parent personal and behavioral outcomes.

      Statistical analyses performed

      Analyses used generalized linear mixed models. Primary comparisons were contrasts between intervention and control groups at postintervention and follow-up, with adjustments for child age and parent education.

      Results

      Compared with control parents, intervention parents showed greater improvement over time in scores of self-efficacy for identifying appropriate portion sizes, with significant differences in adjusted means at both post-intervention (P=0.002) and follow-up (P=0.01). Intervention children were less likely to consume at least one sugar-sweetened beverage daily at post-intervention than control children (P=0.04).

      Conclusions

      The Healthy Home Offerings via the Mealtime Environment Plus program involved the entire family and targeted personal, behavioral, and environment factors important for healthful changes in the home food environment and children’s dietary intake. The intervention improved two nutrition-related behaviors and this may inform the design of future family meal interventions.

      Keywords

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      Biography

      J. A. Fulkerson is a professor, School of Nursing, University of Minnesota, Minneapolis.

      Biography

      S. Friend is evaluation director, School of Nursing, University of Minnesota, Minneapolis.

      Biography

      M. Horning is an assistant professor, School of Nursing, University of Minnesota, Minneapolis.

      Biography

      O. Gurvich is a statistician, School of Nursing, University of Minnesota, Minneapolis.

      Biography

      A. Garwick is a professor, School of Nursing, University of Minnesota, Minneapolis.

      Biography

      M. Y. Kubik is an associate professor, School of Nursing, University of Minnesota, Minneapolis.

      Biography

      M. Draxten is an interventionist, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis.

      Biography

      C. Flattum is intervention director, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis.

      Biography

      D. Neumark-Sztainer is a professor, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis.

      Biography

      M. Story is a professor, Community and Family Medicine and Global Health, Duke University, Durham, NC.