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Healthy Habits, Happy Homes: Randomized Trial to Improve Household Routines for Obesity Prevention Among Preschool-Aged Children
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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“Several other lifestyle factors appear to interact with diet to influence adiposity. These include TV watching, sleep duration, circadian alignment, and possibly maternal-fetal (e.g., placental) influences.28, 41, 67-70”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [68]
In the citing paper
“Greater hours spent TV watching also independently increase obesity and weight gain;28, 68”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [68]
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Metadata
- 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)
- 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
- 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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