Family Obesity Intervention: Motivational Interviewing and Community Support



Status:Active, not recruiting
Conditions:Obesity Weight Loss
Therapuetic Areas:Endocrinology
Healthy:No
Age Range:6 - Any
Updated:1/31/2019
Start Date:March 26, 2015
End Date:July 5, 2020

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Low-income children and children of obese parents are at high risk of obesity. Effective
interventions are needed to target these families to improve the health of the parents and
prevent obesity in the children. The hypothesis is that an intervention that combines
engagement of community organizations, motivational interviewing (MI, a technique proven to
help people set goals that are personally meaningful), and resource mobilization will change
diet and physical activity habits among disadvantaged families. This proposal grew from an
established community-based participatory research (CBPR) partnership between the research
team and community organizations that serve high minority (45-55%), low-income populations.
Partners include a community health center, a food pantry network, a work-force training
program, and other agencies. These partners designed and implemented a successful pilot
project on which this proposal is based. The specific aims of this proposal are 1) To
evaluate the efficacy of a family-targeted obesity intervention based on MI and
resource-mobilization. Hypotheses: In comparison to control families, families participating
in the intervention will demonstrate a) a reduction in BMI for adults, b) an increase in
minutes of moderate physical activity and decreased sedentary time for both adults and
children accelerometer), and c) a reduction in the number of obesity risk behaviors and an
increase in obesity prevention behaviors among children. 2) To examine the mediators of
intervention effects. 3) Identify the types of resources needed most often by intervention
families to support lifestyle change. This randomized controlled trial includes 260
low-income families that contain at least one obese adult and one normal or overweight child
between 6 and 12. The 12-month intervention has two elements. 1) A health coach will use MI
to help families explore ambivalence toward and motivations for change and set goals for
improving diet and physical activity. 2) To support goals, families will be connected with
community agencies that can assist with general (e.g., financial) and goal specific resources
(e.g., food, physical activity opportunities). Collaboration between organizations will
streamline referrals, maximize resources, and facilitate access. Control families will get a
basic screen for needs and information about available community resources. Outcomes are
measured at baseline, 6, 12, and 18 months. This intervention is innovative in that it 1)
focuses on lifestyle changes for the entire family and measures outcomes in adults and
children, 2) combines MI focused on the entire family and community resource referrals
specific to family needs and goals for change, 3) partners community organizations to
coordinate resources for families, and 4) involves partners in all research phases via a CBPR
approach. This contribution will be significant because the proposed intervention, if
successful, can be replicated elsewhere and adapted to the local resource environment to
address adult obesity and prevent childhood obesity in a high-risk population. The study will
also identify the types of resources low-income families need to change diet and physical
activity.


Inclusion Criteria:

- one parent must have a BMI of 30 or above, and be parent or guardian of at least one
child

- between the ages of 6 and 12. Children this age are targeted because they benefit most
from parental involvement

- are old enough to participate in family goal setting and activities, but young enough
to be heavily influenced by family environment.

- a child must live with the obese parent at least 80% of the time.

Exclusion Criteria:

- obese adults or index children with a medical condition or medication that
significantly alters their

1. ability to follow the dietary recommendations (e.g., renal diet, severe food
allergy, celiac disease)

2. mobility (e.g. bed bound or unable to participate in any sort of physical
activity even with assistive devices), or

3. weight

- additionally we will exclude those who have a significant psychiatric disease,
substance abuse disorder or cognitive impairment that would interfere with their
ability to participate

- those with controlled or mild depression would not be excluded

- adults with hypertension, type II diabetes, or glucose intolerance will not be
excluded, as advocated changes are consistent with their needs

- no data will be collected from nonindex children who meet the exclusion criteria.

- obese adults who are currently pregnant at baseline will be excluded because of their
altered weight and dietary patterns. If the obese adult becomes pregnant during the
intervention their family will be allowed to continue in the intervention but the
pregnant adults' anthropometric data will not be collected.

- the intervention will intentionally target low-income families through recruitment
site choices but will not exclude or include families based on income requirements.

- pregnant women will not be targeted but may be included if not the obese adult (see
above).

- weight, height, waist circumference and bioelectrical impedance will not be collected
on pregnant women.
We found this trial at
3
sites
Des Moines, Iowa 50316
Phone: 515-240-6213
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101 Jessup Hall
Iowa City, Iowa 52242
(319) 335-3500
Phone: 319-384-5246
University of Iowa With just over 30,000 students, the University of Iowa is one of...
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Des Moines, Iowa 50314
Phone: 319-384-5246
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