Positive food parenting intervention to promote healthy growth in children at risk for obesity

PROJECT SUMMARY/ABSTRACT
Given our obesogenic environment with abundant access to energy-dense foods, parents often feel lost about
how to help their kids make healthy food choices. This can lead to overly restrictive food parenting practices
that can have negative consequences on child eating and weight outcomes. There is some evidence that
positive food parenting practices (i.e., structure-based and autonomy supporting feeding practices that are
responsive to child needs) are associated with healthy child eating and weight outcomes. In the ongoing K01,
food parenting is being experimentally-manipulated in two conditions, coercive control and structure-based
feeding, with objectively measured child eating behavior assessed in the laboratory after each condition.
Preliminary data suggest that children with overweight consumed fewer calories after the structure-based
feeding condition than they did after the coercive control feeding condition. This suggests that the use of
positive food parenting may support healthier eating behaviors, but more work is needed to examine long-term
impacts on eating and weight outcomes. Taken together, parents need effective tools to help encourage
healthy eating and growth while reducing the risk of obesity. The goal for this program of research is to develop
an evidence-based positive food parenting (i.e., high in structure, autonomy promoting) intervention to give
parents the tools to promote healthy child growth and improve diet quality in children to prevent obesity. To
achieve this goal, there is a need to: identify a novel treatment target (i.e., positive food parenting practices,
focus of the K01); develop and pilot the acceptability and feasibility of this intervention (focus of this R03
proposal); and test the efficacy of this intervention (future R01 proposal). To achieve this, the R03 has two
specific aims. The goal of Specific Aim 1 is to develop a positive food parenting intervention with a focus on
structure-based and autonomy promoting practices. The intervention will be developed based on review of the
research on positive food parenting and feedback from a survey of parents of children ages 5-11. Curriculum
will also be developed to cover the most common feeding challenges mentioned by parents in the survey (e.g.,
child refusing to eat what is served, parent not having time to cook). In Specific Aim 2, the intervention will be
piloted and the feasibility and acceptability of the intervention will be evaluated. This will be done by enrolling
32 parent-child dyads in the 12 session (8 group, 4 individual) intervention using a waitlist control design. Once
the intervention is designed and has been shown to be both acceptable to parents and feasible to conduct, the
efficacy of this intervention will be evaluated in a fully powered R01. This R03 is a critical first step toward
developing an efficacy trial and fully powered randomized controlled trial testing the impact of positive food
parenting practices on child weight and eating behavior in children at risk for obesity.

Grant Number: 5R03DK138232-02
NIH Institute/Center: NIH
Principal Investigator: Katherine Balantekin