Home-Based Nutrition Program for Healthy Eating

Overseen By Kelly Bouchard, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Brown University

Disqualifiers: Underweight, Feeding disorder, Dietary restriction

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 9

257 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a home-based nutrition program, specifically the Home-Based Video and Motivational Interviewing Intervention, can enhance the diet quality of preschool-aged children in low-income, Latinx/Hispanic families. Researchers seek to discover if this program encourages healthier eating in children, alters parental feeding practices, and increases the availability of healthy foods at home. Participants will engage with a support coach through home visits, phone calls, and text messages over six months. Families that primarily speak English or Spanish and have a preschooler with whom they eat dinner at least three times a week may be well-suited for this study. As an unphased trial, this study provides families the chance to contribute to significant research that could improve children's health and nutrition.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this home-based nutrition program is safe for children?

Research shows that the home-based video and motivational interviewing program is safe for families. This program includes home visits, phone calls with a support coach, written materials, and text messages. Previous studies aimed at improving diet quality in preschool children have found that families handle these methods well. Similar past studies reported no serious side effects. Participants usually find the program acceptable and manageable, indicating it is safe for families to join. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Home-Based Nutrition Program because it brings a fresh approach to promoting healthy eating habits in families. Unlike traditional nutrition programs that might rely solely on educational materials or periodic consultations, this program uniquely combines home visits, motivational interviewing, and regular text message reminders. This tailored approach not only educates but also actively engages and supports parents in setting and achieving specific dietary goals for their families. By delivering the intervention in both English and Spanish, it also aims to reach a broader audience, making it more inclusive than many existing options.

What evidence suggests that this home-based nutrition program is effective for improving diet quality in preschool-aged children?

Research has shown that home-based programs can improve children's diets. This trial tests the Home-Based Video and Motivational Interviewing Intervention, known as Strong Families Start at Home, to assess its impact on children's eating habits and parental feeding practices. The method employs motivational interviewing to help individuals find the drive for positive change, supplemented by regular support through home visits, phone calls, and text messages. Although final results are pending, early findings suggest promise in facilitating healthier eating habits for families. This approach aims to increase the availability of healthy foods at home and enhance overall family nutrition. ^{1 2 4 5 6}

Who Is on the Research Team?

Alison Tovar, PhD MPH

Principal Investigator

Brown University

Are You a Good Fit for This Trial?

This trial is for Latinx/Hispanic primary caregivers, at least 18 years old, who have a child aged 2-5. They must live with the child most of the time, share at least three evening meals per week with them, and be willing to record one meal. Participants need a smartphone but shouldn't have been in the R34 study.

Inclusion Criteria

Self-identity as Latinx/Hispanic

Eat a minimum of three evening meals per week with the child

Not have participated in the R34 study

Exclusion Criteria

A doctor or WIC provider has told them that their child was underweight in the past 6 months

The child has a diagnosed feeding disorder or dietary restriction that impacts how they eat

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a home-based parental nutrition intervention including home visits, phone calls, and text messages to improve diet quality

6 months

3 home visits, 3 phone calls, bi-weekly text messages

Follow-up

Participants are monitored for changes in diet quality and food parenting practices

6 months

Follow-up assessments at 6 and 12 months

What Are the Treatments Tested in This Trial?

Interventions

• Home-Based Video and Motivational Interviewing Intervention

Trial Overview

The trial tests if a home-based nutrition program can improve children's diets. It involves monthly home visits and calls from a support coach over three months, plus educational materials and texts for six months. The effectiveness will be compared to a control group receiving different materials.

How Is the Trial Designed?

Group I: Home-Based Video and Motivational Interviewing Intervention Experimental Treatment 1 Intervention

The intervention will be delivered in English or Spanish by a trained CHW and consists of three home-based visits with tailored print materials, text-messages delivered 2x/week, followed by monthly tailored print materials and phone calls during the last three months of the intervention. For in-home visits, the CHW will deliver a Motivational Interviewing session based on scripts developed in the R34. For phone calls, parents will receive a 30-minute Motivational Interviewing phone call to check in on goals and barriers and reinforce earlier concepts. For text messages, parents will be sent two times/week messages related to objectives targeted during that month's visit, such as parents setting good examples and giving children autonomy in eating. For print materials, parents will receive printed materials, highlighting nutrition and parental feeding guidance.

Group II: Read Educate and Develop Youth (READY) Comparison Active Control 1 Intervention

As done in the R34, the comparison group will receive an attention contact control intervention about school readiness promotion adapted from R.E.A.D.Y. (Read Educate and Develop Youth) designed by the Michigan Department of Education (Refs). Families in the comparison arm will receive the same intervention components as the intervention arm, but these will be focused on child reading rather than nutrition. Parents will send a video of themselves reading with a child, receive 3 home visits and 48 text-messages as well as newsletters for each visit. Instead of receiving cooking materials during the second home visit, they will receive books to read with their children.

Who Is Running the Clinical Trial?

Brown University

Lead Sponsor

Trials

480

Recruited

724,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

The study involving 36 parent and adult caregiver-child dyads showed that motivational interviewing (MI) by registered dietitians can lead to improvements in the dietary quality of caregivers, as indicated by increased Healthy Eating Index (HEI) scores.

Improvements in the home food environment were also observed, suggesting that MI not only benefits the caregivers' diets but may also positively influence children's dietary habits and the overall home setting for healthier eating.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary Support for the Use of Motivational Interviewing to Improve Parent/Adult Caregiver Behavior for Obesity and Cancer Prevention. Braun, A., Portner, J., Xu, M., et al.[2023]

The HOME Plus intervention, which included 81 families and 10 group sessions, effectively promoted healthful eating and increased family meal frequency, showing significant behavior changes in participants.

Motivational interviewing (MI) was well-received, with an 87% completion rate for goal-setting calls, and over 85% of families reported achieving their goals, indicating MI's effectiveness in supporting behavior change in childhood obesity prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Example of How to Supplement Goal Setting to Promote Behavior Change for Families Using Motivational Interviewing. Draxten, M., Flattum, C., Fulkerson, J.[2018]

The HOME Plus intervention, which included 81 families with children aged 8-12, successfully promoted healthy eating and increased family meal participation through ten monthly sessions and motivational calls, achieving a high average attendance of 68%.

Families reported high satisfaction with the program, particularly enjoying cooking together and learning new healthy recipes, indicating that community-based interventions can effectively engage families in improving dietary quality and preventing obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity. Flattum, C., Draxten, M., Horning, M., et al.[2018]

This study involves a randomized controlled trial with 236 low-income, racially diverse families, focusing on a 12-month intervention that combines motivational interviewing (MI) and community resource mobilization to promote healthy behaviors and prevent obesity.

The intervention aims to improve key outcomes such as Body Mass Index (BMI) and physical activity levels in both parents and children, potentially establishing a sustainable model for supporting families at risk for obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of a community-based obesity intervention utilizing motivational interviewing and community resource mobilization for low-income families: Study protocol and baseline characteristics. Andino, J., Park-Mroch, J., Francis, SL., et al.[2023]

A pilot study involving 104 low-income parents showed that a home-based cooking intervention significantly increased their confidence in preparing vegetables and encouraged them to try a variety of vegetables, with 96% participation in activities.

Most home visitors found the cooking intervention acceptable and feasible, suggesting that home visiting programs could effectively improve vegetable consumption attitudes and behaviors among families, although further research is needed to evaluate actual changes in vegetable intake.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Cooking Intervention to Increase Vegetable Consumption by Parents With Children Enrolled in an Early Head Start Home Visiting Program: A Pilot Study in Portland, Oregon, 2013-2014. Izumi, BT., Eckhardt, CL., Wilson, DP., et al.[2019]

The RD Parent Empowerment Program, which included four workshops for low-income families, led to a significant improvement in healthy dietary and physical activity choices among 123 participating parents, with an average increase of 4.3 points on the Family Nutrition and Physical Activity survey (P<0.01).

Participants credited the program's success to the site leaders and reported positive behavior changes, indicating that structured support and community engagement are key factors in promoting healthier family habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The RD parent empowerment program creates measurable change in the behaviors of low-income families and children: an intervention description and evaluation. Hand, RK., Birnbaum, AS., Carter, BJ., et al.[2022]

The Strong Families Start at Home pilot trial demonstrated feasibility and high acceptability, with 63% of participating families retained over 6 months, despite challenges posed by COVID-19.

The intervention led to significant improvements in healthy eating behaviors, including increased consumption of whole fruits and reduced sodium intake, along with enhanced food parenting practices such as regular meal timing and minimizing distractions during meals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Results from the Strong Families Start at Home/Familias Fuertes Comienzan en Casa: feasibility randomised control trial to improve the diet quality of low-income, predominantly Hispanic/Latinx children. Tovar, A., Fox, K., Gans, KM., et al.[2023]

Community-based cooking skill interventions significantly boost adults' confidence in their cooking abilities, regardless of age or setting.

While these programs show some positive effects on increasing fruit and vegetable intake, the evidence is inconsistent, highlighting the need for better study designs and long-term evaluations to fully understand their impact on dietary habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community Interventions to Improve Cooking Skills and Their Effects on Confidence and Eating Behaviour. Garcia, AL., Reardon, R., McDonald, M., et al.[2022]

A training program on motivational interviewing significantly improved WIC counselors' knowledge of effective obesity prevention strategies, with knowledge retention observed three months post-training.

Despite the increased knowledge, there was no improvement in the quality of documented behavior change goals in client charts, indicating that further support and time are necessary for counselors to effectively apply these strategies in practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Impact of Training in Obesity Prevention Methods on the Counseling, Knowledge, and Skills of WIC Nutritionists in Georgia, 2014-2015. Palmer, W., Henderson, D., Stahnke, B., et al.[2018]

Preschoolers participating in the family-based obesity intervention (LAUNCH) showed a significant improvement in diet quality, as measured by the Healthy Eating Index-2010, compared to those in motivational interviewing (MI) and standard care (STC) conditions.

The LAUNCH intervention also led to a reduction in the number of 'red' foods (high in fat and sugar) available in the home environment, indicating a positive change in dietary habits and food availability for families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in diet quality and home food environment in preschool children following weight management. Robson, SM., Ziegler, ML., McCullough, MB., et al.[2020]

Citations

1.

researchprotocols.org

researchprotocols.org/2025/1/e73923

Strong Families Start at Home/Familias Fuertes Comienzan ...

Data analysis is expected to conclude in 2028. Conclusions: Findings will determine the efficacy of the intervention to improve child diet ...

2.

clinicaltrials.gov

clinicaltrials.gov/study/NCT06099288

Strong Families Start at Home/Familias Fuertes Comienzan ...

The goal of this clinical trial is to test the ability of a home-based parental nutrition intervention to improve diet quality in preschool aged children.

3.

sciencedirect.com

sciencedirect.com/org/science/article/pii/S1929074825005840

Strong Families Start at Home/Familias Fuertes Comienzan ...

Findings will determine the efficacy of the intervention to improve child diet quality and parental feeding practices, which will ultimately ...

4.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/40929716/

Protocol for a Randomized Controlled Trial

The Strong Families Start at Home/Familias Fuertes Comienzan en Casa (SFSH) was a 6-month, home-based, pilot randomized-controlled ...

5.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/36691686/

feasibility randomised control trial to improve the diet quality of ...

To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition ...

6.

cdn.clinicaltrials.gov

cdn.clinicaltrials.gov/large-docs/91/NCT03923491/Prot_001.pdf

Strong Families Start at Home

The proposed research will lay the groundwork for a larger RCT to educate, support, motivate, and empower low- income parents to prepare healthy meals and use ...