Nutrition Education Program for Childhood Obesity

Overseen By Mamie White, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Baylor College of Medicine

Must not be taking: Weight medications

Disqualifiers: Children with disabilities, others

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

Compensation: Varies

Number of Visits: Unknown

30 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes parents of children on prescription medications that affect weight or appetite.

What data supports the effectiveness of the treatment Revised ESBA for childhood obesity?

Research shows that family-based nutrition interventions, which include setting family goals and modifying the home food environment, can improve dietary behaviors in children. Additionally, a school-based program combining behavior modification, nutrition education, and physical activity led to significant weight loss in obese children, suggesting that comprehensive educational programs can be effective in managing childhood obesity. ^{1 2 3 4 5}

Is the Nutrition Education Program for Childhood Obesity safe for children?

The available research on nutrition education programs, including family-based interventions and the EFNEP curriculum, suggests they are generally safe for children. These programs focus on improving dietary habits and involve family participation, which are considered safe approaches to managing childhood obesity. ^{2 5 6 7 8}

How does the Revised ESBA treatment differ from other treatments for childhood obesity?

The Revised ESBA treatment is unique because it integrates the Expanded Food and Nutrition Education Program (EFNEP) curriculum, which focuses on practical nutrition education and behavior change strategies, into a medical clinic setting to support pediatric obesity prevention. This approach combines family-based goals, hands-on nutrition education, and modifying the home food environment, which are not typically emphasized in standard treatments for childhood obesity. ^{2 8 9 10 11}

What is the purpose of this trial?

To assess feasibility and acceptability of of integrating Food Rx and Best Feeding Practices with EFNEP participants via a pilot study.

Eligibility Criteria

This trial is for parents living in Harris or Fort Bend counties with a child aged 4-8. Participants must be able to communicate in English or Spanish, have telephone access, and be able to use the internet via a smart device or computer.

Inclusion Criteria

Living in Harris or Fort Bend counties

I am a parent of a child aged between 4 and 8 years.

Having ready access to a telephone

Exclusion Criteria

I am a parent of a child with disabilities and/or on medications affecting weight/appetite.

Parents who are not able to complete self-report questionnaires

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the ESBA-FFYF feeding curriculum in classes using standardized implementation protocols

3 months

Follow-up

Participants are monitored for changes in feeding practices using the Food Parenting Inventory

4 weeks

Treatment Details

Interventions

• Revised ESBA

Trial Overview The study is testing 'Revised ESBA', which integrates Food Rx (prescriptions for healthy foods) with Best Feeding Practices within the EFNEP program to improve children's eating habits and prevent obesity.

Participant Groups

Group I: ESBA + Feeding Practices Experimental Treatment 1 Intervention

The intervention site staff will implement the ESBA-FFYF feeding curriculum in classes using standardized implementation protocols.

Group II: Usual Practice - ESBA Active Control 1 Intervention

The control group sites will receive the existing ESBA curriculum which is their usual practice.

Who Is Running the Clinical Trial?

Baylor College of Medicine

Lead Sponsor

Trials

1,044

Recruited

6,031,000+

Prairie View A&M University

Collaborator

Trials

1

Recruited

30+

Prairie View A&M University

Collaborator

Trials

1

Recruited

30+

University of Houston

Collaborator

Trials

155

Recruited

48,600+

Findings from Research

An educational intervention for family medicine and pediatric providers led to a significant increase in referrals for overweight children from 6% to 16% and laboratory testing from 14% to 26%.

Despite improvements in referrals and lab tests, there were no changes in discussions about weight status or documentation practices, indicating a need for further strategies to enhance these aspects of pediatric obesity management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary Care Provider Knowledge and Practice Patterns Regarding Childhood Obesity. Busch, AM., Hubka, A., Lynch, BA.[2019]

A review of eight randomized controlled trials found that family-based nutrition interventions can effectively improve dietary behaviors in children aged 5-18, highlighting the importance of setting family goals and modifying the home food environment.

Successful interventions often included hands-on teaching methods, such as games and group activities, as well as providing incentives like fruit and vegetable vouchers, although concerns about study quality, such as blinding and instrument reliability, were noted.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-based nutrition interventions for obesity prevention among school-aged children: a systematic review. Perdew, M., Liu, S., Naylor, PJ.[2021]

In a 10-week school-based program involving 63 obese children aged 5 to 12, 95% of participants lost weight, achieving an average weight loss of 4.4 kg and a 15.4% decrease in their percentage overweight.

The program was significantly more effective than no intervention, as only 21% of a control group of obese children lost weight, highlighting the importance of comprehensive behavior modification and support in managing childhood obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A school-based behavior modification, nutrition education, and physical activity program for obese children. Brownell, KD., Kaye, FS.[2018]

In a 2-year study involving 65 overweight and obese children, those who received a multi-component family-focused education package showed a significant reduction in BMI SDS compared to those who only received body composition monitoring during the control period.

The intervention group had a greater success rate, with 33% achieving a target reduction in BMI SDS, and they gained 5.7 kg less over the study duration, indicating the effectiveness of the educational approach in managing childhood obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of a multi-disciplinary family-based programme for treating childhood obesity (the Family Project). Coppins, DF., Margetts, BM., Fa, JL., et al.[2015]

Dietary interventions for obese children can lead to relative weight loss, as indicated by meta-analyses of 37 randomized controlled trials, although the specifics of these dietary treatments are often poorly documented.

The overall effectiveness of dietary treatments for childhood obesity remains unclear due to the lack of high-quality studies and the variability in study designs and outcomes, highlighting the need for better research in this critical area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring effectiveness of dietetic interventions in child obesity: a systematic review of randomized trials. Collins, CE., Warren, J., Neve, M., et al.[2018]

A systematic review of 116 articles found that dietary interventions generally lead to significant short-term weight loss in children and adolescents who are overweight or obese, but many studies lacked rigorous design and follow-up.

There is a critical need for high-quality research to determine the best dietary strategies for managing pediatric obesity, with a focus on long-term sustainability and detailed reporting of dietary interventions and outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review of interventions in the management of overweight and obese children which include a dietary component. Collins, CE., Warren, JM., Neve, M., et al.[2011]

The study evaluated different strategies to improve feeding practices in early care and education, finding that the combination of de-implementation and enhanced support (D + E) led to significantly more positive interactions and role modeling during nutrition lessons compared to other strategies.

The D + E group also showed a reduction in negative comments and an increase in positive comments during meals, indicating that these strategies can effectively promote healthier feeding environments despite challenges like interruptions from COVID.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies. Swindle, T., Rutledge, JM., Zhang, D., et al.[2022]

The Expanded Food and Nutrition Education Program (EFNEP) curriculum, Eating Smart-Being Active (ESBA), significantly improved nutrition-related behaviors in adults, including food resource management, food safety, nutrition knowledge, and physical activity levels, with positive changes observed across multiple states.

ESBA outperformed previous curricula in promoting better outcomes for fruit and vegetable intake and overall nutrition, demonstrating its effectiveness and suitability for community nutrition programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcome effectiveness of the widely adopted EFNEP curriculum Eating Smart-Being Active. Auld, G., Baker, S., Conway, L., et al.[2014]

The Expanded Food and Nutrition Education Program (EFNEP) was successfully integrated into five medical clinics, with physicians generating 686 referrals and 106 parents participating in the 8-week pediatric obesity prevention intervention.

Parents reported significant improvements in their children's behaviors related to sleep, screen time, physical activity, and nutrition, indicating that the intervention was both feasible and beneficial for families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of Colocating a Nutrition Education Program into a Medical Clinic Setting to Facilitate Pediatric Obesity Prevention. Shilts, MK., Diaz Rios, LK., Panarella, KH., et al.[2021]

Culinary education interventions for children from low-income families are mostly school-based and focus on teaching children cooking skills, which can help improve nutrition and potentially reduce obesity rates.

Only a small number of studies (9 out of 370) met the criteria for inclusion, indicating a need for more comprehensive research and development in culinary education programs, particularly in involving parents and training program leaders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Culinary Education Programs for Children in Low-Income Households: A Scoping Review. Li, PP., Mackey, G., Callender, C., et al.[2020]

The Nutrition Mission, a 14-week health promotion program led by medical students, significantly increased nutrition and exercise knowledge among 35 fifth-grade students in Houston, with scores rising from 68.1% to 78.1% (P<0.001).

The intervention demonstrated feasibility in a socioeconomically disadvantaged school setting, suggesting that student-led health education can effectively enhance knowledge in nutrition and exercise among elementary students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition Mission. Patel, CB., Strommen, JJ., Elliott, AM., et al.[2016]

References

1. United States pubmed.ncbi.nlm.nih.gov

Primary Care Provider Knowledge and Practice Patterns Regarding Childhood Obesity. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Family-based nutrition interventions for obesity prevention among school-aged children: a systematic review. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

A school-based behavior modification, nutrition education, and physical activity program for obese children. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness of a multi-disciplinary family-based programme for treating childhood obesity (the Family Project). [2015]

5. United States pubmed.ncbi.nlm.nih.gov

Measuring effectiveness of dietetic interventions in child obesity: a systematic review of randomized trials. [2018]

6. Australia pubmed.ncbi.nlm.nih.gov

Systematic review of interventions in the management of overweight and obese children which include a dietary component. [2011]

7. Switzerland pubmed.ncbi.nlm.nih.gov

De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Outcome effectiveness of the widely adopted EFNEP curriculum Eating Smart-Being Active. [2014]

9. United States pubmed.ncbi.nlm.nih.gov

Feasibility of Colocating a Nutrition Education Program into a Medical Clinic Setting to Facilitate Pediatric Obesity Prevention. [2021]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Culinary Education Programs for Children in Low-Income Households: A Scoping Review. [2020]

11. United States pubmed.ncbi.nlm.nih.gov

Nutrition Mission. [2016]