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Growing Right Onto Wellness (GROW): Changing Early Childhood Body Mass Index (BMI) Trajectories

Not Applicable
Completed
Conditions
Overweight and Obesity
Childhood Obesity
Interventions
Behavioral: GROW Smarter
Behavioral: GROW Healthier
Registration Number
NCT01316653
Lead Sponsor
Vanderbilt University
Brief Summary

The purpose of this study is to conduct a randomized controlled trial that examines how a family based, community centered intervention effects early childhood BMI trajectories.

Detailed Description

Increases in sedentary lifestyle and high calorie food consumption, among other factors, have contributed to epidemic levels of childhood obesity in the US. Children who are overweight during the preschool period are more likely to become overweight adolescents and obese adults. Food preferences and activity habits set in early childhood can profoundly influence lifelong trajectories for Body Mass Index (BMI) and health. Specifically, rapid BMI gain in early childhood has been established to affect adulthood mortality and morbidity. Unfortunately, the longer such unhealthy patterns are in place, the more difficult it can be to reverse them. Therefore, healthy lifestyle interventions targeted at children as early as preschool have enormous potential to affect lifelong health. Furthermore, nutrition and activity patterns are determined not only at the child level, but within the family and the community.

This study will assess the impact of a family-based and community centered multilevel behavioral intervention addressing nutrition and physical activity with high risk parent-preschool children dyads to promote pediatric obesity prevention. The 7 year study will follow 600 parent preschool child dyads, half of whom will be randomized into the intervention condition which will utilize a health literate approach, build new social networks, utilize behavior modification tools including goal setting, self monitoring, and problem solving, and create behavior-environmental synergy with cues to action for use of the built environment for healthy behaviors. Both the intervention and control group (separately) will receive the control condition in which parent-child dyads will receive a literacy promotion/school success curriculum.

The primary outcome of interest will be early childhood BMI trajectories measured at multiple time points over the three year RCT. Additional measures collected throughout the study from children and parents will include: tricep skin fold, waist circumference, actigraphy, 3-day diet recalls, questionnaires, social network data, and saliva to assess a genetics/epigenetics associated with obesity. Consistent with a multilevel systems approach, the investigators will develop and assess built environment changes related to obesity prevention. Moreover, working with the study's community partners, the investigators will evaluate how this approach affects local policy.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
610
Inclusion Criteria
  • English or Spanish speaking
  • Address in select zip code regions around participating Metro community centers
  • Parental commitment to consistent participation
  • Consistent phone access for 3 years
  • Child aged 3-5 years old
  • Child BMI ≥ 50% and < 95% (no diagnosis of failure to thrive or difficulty with appropriate weight gain)
  • Healthy parent and child (without medical conditions necessitating limited physical activity)
  • Parent ≥ 18 years of age
Exclusion Criteria
  • Non English or Spanish speaking
  • Address outside select zip code regions around participating Metro community centers
  • Lack of parental commitment to consistent participation
  • Lack of consistent phone access
  • Child outside specified age range
  • Child BMI < 50% or ≥ 95%
  • Parents and/or children who are diagnosed with medical illnesses where regular exercise might be contraindicated
  • Parent < 18 years of age

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GROW SmarterGROW SmarterLibrary based program to promote early literacy
GROW HealthierGROW SmarterHealthy lifestyle intervention focused on building healthy lifestyle skills for preschool children and participating parents and building new social networks between the intervention group members.
GROW HealthierGROW HealthierHealthy lifestyle intervention focused on building healthy lifestyle skills for preschool children and participating parents and building new social networks between the intervention group members.
Primary Outcome Measures
NameTimeMethod
Early Childhood BMI TrajectoryBaseline, 3 months, 9 months, 12 months, 24 months, and 36 months
Secondary Outcome Measures
NameTimeMethod
Average daily energy intake (kcal)Baseline, 12 months, 24 months, and 36 months
Percentage of Energy Intake from CarbohydratesBaseline, 12 months, 24 months, and 36 months
Percentage of Energy Intake from ProteinBaseline, 12 months, 24 months, and 36 months
Parent community center use with childBaseline, 12 months, 24 months, and 36 months

never versus at least once

Percentage of Energy Intake from FatBaseline, 12 months, 24 months, and 36 months
Average daily time (minutes) spent in moderate and vigorous physical activityBaseline, 12 months, 24 months, and 36 months
Average daily time (minutes) spent in rest and sedentary behaviorBaseline, 12 months, 24 months, and 36 months
Parent BMIBaseline, 3 months, 9 months, 12 months, 24 months, and 36 months
Parent Waist CircumferenceBaseline, 12 months, 24 months, and 36 months
Parent Triceps SkinfoldBaseline, 12 months, 24 months, and 36 months
Child Waist CircumferenceBaseline, 12 months, 24 months, and 36 months
Child Triceps SkinfoldBaseline, 12 months, 24 months, and 36 months

Trial Locations

Locations (1)

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

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