TY - JOUR
T1 - Designing a childhood obesity preventive intervention using the multiphase optimization strategy
T2 - The Healthy Bodies Project
AU - Francis, Lori A.
AU - Nix, Robert
AU - BeLue, Rhonda
AU - Keller, Kathleen L.
AU - Kugler, Kari Christine
AU - Rollins, Brandi
AU - Williams, Jennifer Savage
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This material is based upon work that was supported by the National Institute of Food and Agriculture, US Department of Agriculture, under award number 2015-68001-23233. The Pennsylvania State University sponsored this trial, through the Office of Sponsored Programs (OSP #205859, [email protected]). Neither the funder nor the sponsor had any role in the study design or execution, and did not have a role in analyses, interpretation of the data, or the decision to submit results.
Funding Information:
The authors would like to acknowledge Drs Kirsten Davison, Jennifer Fisher, and Susan Johnson for their advice and consultation on this project. The support of Penn State Extension and the Penn State Early Childhood Development Institute was greatly appreciated. Finally, they would like to thank the childcare center directors, teachers, parents, and children whose participation made this work possible. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This material is based upon work that was supported by the National Institute of Food and Agriculture, US Department of Agriculture, under award number 2015-68001-23233. The Pennsylvania State University sponsored this trial, through the Office of Sponsored Programs (OSP #205859, [email protected]). Neither the funder nor the sponsor had any role in the study design or execution, and did not have a role in analyses, interpretation of the data, or the decision to submit results.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023/8
Y1 - 2023/8
N2 - Background/Aims: Preventing the development of childhood obesity requires multilevel, multicomponent, comprehensive approaches. Study designs often do not allow for systematic evaluation of the efficacy of individual intervention components before the intervention is fully tested. As such, childhood obesity prevention programs may contain a mix of effective and ineffective components. This article describes the design and rationale of a childhood obesity preventive intervention developed using the multiphase optimization strategy, an engineering-inspired framework for optimizing behavioral interventions. Using a series of randomized experiments, the objective of the study was to systematically test, select, and refine candidate components to build an optimized childhood obesity preventive intervention to be evaluated in a subsequent randomized controlled trial. Methods: A 24 full factorial design was used to test the individual and combined effects of four candidate intervention components intended to reduce the risk for childhood obesity. These components were designed with a focus on (a) improving children’s healthy eating behaviors and nutrition knowledge, (b) increasing physical activity and reducing sedentary activity in the childcare setting, (c) improving children’s behavioral self-regulation, and (d) providing parental web-based education to address child target outcomes. The components were tested with approximately 1400 preschool children, ages 3–5 years in center-based childcare programs in Pennsylvania, the majority of which served predominantly Head-Start eligible households. Primary child outcomes included healthy eating knowledge, physical and sedentary activity, and behavioral self-regulation. Secondary outcomes included children’s body mass index and appetitive traits related to appetite regulation. Results: Four intervention components were developed, including three classroom curricula designed to increase preschool children’s nutrition knowledge, physical activity, and behavioral, emotional, and eating regulation. A web-based parent education component included 18 lessons designed to improve parenting practices and home environments that would bolster the effects of the classroom curricula. A plan for analyzing the specific contribution of each component to a larger intervention was developed and is described. The efficacy of the four components can be evaluated to determine the extent to which they, individually and in combination, produce detectable changes in childhood obesity risk factors. The resulting optimized intervention should later be evaluated in a randomized controlled trial, which may provide new information on promising targets for obesity prevention in young children. Conclusion: This research project highlights the ways in which an innovative approach to the design and initial evaluation of preventive interventions may increase the likelihood of long-term success. The lessons from this research project have implications for childhood obesity research as well as other preventive interventions that include multiple components, each targeting unique contributors to a multifaceted problem.
AB - Background/Aims: Preventing the development of childhood obesity requires multilevel, multicomponent, comprehensive approaches. Study designs often do not allow for systematic evaluation of the efficacy of individual intervention components before the intervention is fully tested. As such, childhood obesity prevention programs may contain a mix of effective and ineffective components. This article describes the design and rationale of a childhood obesity preventive intervention developed using the multiphase optimization strategy, an engineering-inspired framework for optimizing behavioral interventions. Using a series of randomized experiments, the objective of the study was to systematically test, select, and refine candidate components to build an optimized childhood obesity preventive intervention to be evaluated in a subsequent randomized controlled trial. Methods: A 24 full factorial design was used to test the individual and combined effects of four candidate intervention components intended to reduce the risk for childhood obesity. These components were designed with a focus on (a) improving children’s healthy eating behaviors and nutrition knowledge, (b) increasing physical activity and reducing sedentary activity in the childcare setting, (c) improving children’s behavioral self-regulation, and (d) providing parental web-based education to address child target outcomes. The components were tested with approximately 1400 preschool children, ages 3–5 years in center-based childcare programs in Pennsylvania, the majority of which served predominantly Head-Start eligible households. Primary child outcomes included healthy eating knowledge, physical and sedentary activity, and behavioral self-regulation. Secondary outcomes included children’s body mass index and appetitive traits related to appetite regulation. Results: Four intervention components were developed, including three classroom curricula designed to increase preschool children’s nutrition knowledge, physical activity, and behavioral, emotional, and eating regulation. A web-based parent education component included 18 lessons designed to improve parenting practices and home environments that would bolster the effects of the classroom curricula. A plan for analyzing the specific contribution of each component to a larger intervention was developed and is described. The efficacy of the four components can be evaluated to determine the extent to which they, individually and in combination, produce detectable changes in childhood obesity risk factors. The resulting optimized intervention should later be evaluated in a randomized controlled trial, which may provide new information on promising targets for obesity prevention in young children. Conclusion: This research project highlights the ways in which an innovative approach to the design and initial evaluation of preventive interventions may increase the likelihood of long-term success. The lessons from this research project have implications for childhood obesity research as well as other preventive interventions that include multiple components, each targeting unique contributors to a multifaceted problem.
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U2 - 10.1177/17407745231167115
DO - 10.1177/17407745231167115
M3 - Article
C2 - 37077032
AN - SCOPUS:85153474654
SN - 1740-7745
VL - 20
SP - 434
EP - 446
JO - Clinical Trials
JF - Clinical Trials
IS - 4
ER -