Food for Thought: A Parental Internet-based Intervention to Treat Childhood Obesity in Preschool-aged Children

Approximately 21.2% of children aged 2-5 years are considered overweight or obese, and the consequences of the high rates in pediatric obesity are extensive, as childhood obesity is linked to both physical and psychosocial complications. This study evaluated the efficacy of Food for Thought (FFT), a 16-week Internet-based behavioral intervention for parents of children aged 2-6. FFT included a study website with weekly sessions; online self-monitoring diary forms for diet, activity, and weight; web links to related sites; and a monitored message board. FFT was compared to Bright Futures (BF), a website that provided information about children\u27s healthy eating and activity. A sample of 56 parents/guardians of obese children aged 2-6 (mean=4.7 ±1.2) with an average BMI percentile of 99.2 were randomized to FFT or BF. Assessments were conducted at baseline and at 4 months (post-treatment). Only 30 of the 56 participants returned for post-treatment assessment, so analyses were run (a) for only completers, and (b) as intent to treat (ITT) with baseline values carried forward. The primary outcome variable, BMI z-score (zBMI; BMI converted to a standard score for age and sex), was analyzed using an analysis of variance (ANOVA), and secondary behavior change outcomes (i.e., eating and activity habits) were analyzed with a multivariate analysis of variance (MANOVA). Results of the study indicated no effect of FFT, as compared with BF, on child zBMI, BMI percentile, or any weight-related behaviors in the ITT or completers analyses. However, in both the ITT and completers analyses a time effect was found, showing that children in both groups had a significant decrease in zBMI at post-treatment. However, a significant reduction in BMI percentile was not found, and the minimal zBMI change observed in this study is unlikely to produce improvements in health parameters. Future studies are needed in order to determine how the magnitude of the effects from FFT can be improved, with the goal of a treatment that is maximally robust and disseminable