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Cited by 253Obesity, Physical Activity, DietNutrition, Health and Food BehaviorChild Development and Digital Technology

Healthy Habits, Happy Homes: Randomized Trial to Improve Household Routines for Obesity Prevention Among Preschool-Aged Children

Haines, Jess, McDonald, Julia, O’Brien, Ashley, Sherry, Bettylou, Bottino, Clement J., Schmidt, Marie Evans, Taveras, Elsie M.·2013·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2013.2356
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Abstract

IMPORTANCE: Racial/ethnic and socioeconomic disparities exist across risk factors for childhood obesity. OBJECTIVE: To examine the effectiveness of a home-based intervention to improve household routines known to be associated with childhood obesity among a sample of low-income, racial/ethnic minority families with young children. DESIGN: Randomized trial. SETTING: The intervention was delivered in the families' homes. PARTICIPANTS: The study involved 121 families with children aged 2 to 5 years who had a television (TV) in the room where he or she slept; 111 (92%) had 6-month outcome data (55 intervention and 56 control). The mean (SD) age of the children was 4.0 (1.1) years; 45% were overweight/obese. Fifty-two percent of the children were Hispanic, 34% were black, and 14% were white/other. Nearly 60% of the families had household incomes of $20,000 or less. INTERVENTIONS: The 6-month intervention promoted 4 household routines, family meals, adequate sleep, limiting TV time, and removing the TV from the child's bedroom, using (1) motivational coaching at home and by phone, (2) mailed educational materials, and (3) text messages. Control subjects were mailed materials focused on child development. MAIN OUTCOMES AND MEASURES: Change in parent report of frequency of family meals (times/wk), child sleep duration (hours/d), child weekday and weekend day TV viewing (hours/d), and the presence of a TV in the room where the child slept from baseline to 6 months. A secondary outcome was change in age- and sex-adjusted body mass index (calculated as weight in kilograms divided by height in meters squared). RESULTS: Compared with control subjects, intervention participants had increased sleep duration (0.75 hours/d; 95% CI, 0.06 to 1.44; P = .03), greater decreases in TV viewing on weekend days (-1.06 hours/d; 95% CI, -1.97 to -0.15; P = .02), and decreased body mass index (-0.40; 95% CI, -0.79 to 0.00; P = .05). No significant intervention effect was found for the presence of a TV in the room where the child slept or family meal frequency. CONCLUSIONS AND RELEVANCE: Our results suggest that promoting household routines, particularly increasing sleep duration and reducing TV viewing, may be an effective approach to reduce body mass index among low-income, racial/ethnic minority children. Longer-term studies are needed to determine maintenance of behavior change. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01565161.

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Authors
Haines, J., McDonald, J., O’Brien, A., Sherry, B., Bottino, C. J., Schmidt, M. E., & Taveras, E. M.
Affiliations
  • University of Guelph (CA)
  • Harvard University (US)
  • Centers for Disease Control and Prevention (US)
  • Boston Children's Hospital (US)
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2013-11-01
Volume
167
Issue
11
Pages
1072
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2013.2356
OpenAlex
W2009879711
Cited by
253
References
45
Citations by year
2026: 12 · 2025: 17 · 2024: 16 · 2023: 14 · 2022: 12 · 2021: 27 · 2020: 23 · 2019: 33 · 2018: 25 · 2017: 15 · 2016: 18 · 2015: 17 · 2014: 19 · 2013: 4
FWCI
19.72
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Center for Chronic Disease Prevention and Health Promotion (1U48DP00194)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Social Sciences › Education › Child Development and Digital Technology
Keywords
childhood obesity, home-based intervention, family routines, sleep duration, television viewing, screen time, family meals, body mass index, low-income households, motivational coaching, text messaging, parental education, obesity prevention, socioeconomic disparities, Hispanic children, Black children, children aged 2-5 years
MeSH terms
Child, Preschool, Counseling, Female, Habits, Health Promotion, Humans, Life Style, Male, Obesity, Poverty, Sleep, Social Class, Television, Health Behavior, Body Mass Index, Meals

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