Rationale, design and study protocol of the 'Strong Families Start at Home' feasibility trial to improve the diet quality of low-income, ethnically diverse children by helping parents improve their feeding and food preparation practices

Katelyn Fox; Kim Gans; Karen McCurdy; Patricia Markham Risica; Ernestine Jennings; Amy Gorin; George D Papandonatos; Alison Tovar

doi:10.1016/j.conctc.2020.100583

Rationale, design and study protocol of the 'Strong Families Start at Home' feasibility trial to improve the diet quality of low-income, ethnically diverse children by helping parents improve their feeding and food preparation practices

Contemp Clin Trials Commun. 2020 Jun 16:19:100583. doi: 10.1016/j.conctc.2020.100583. eCollection 2020 Sep.

Authors

Katelyn Fox¹, Kim Gans^{2

3

4}, Karen McCurdy⁵, Patricia Markham Risica^{3

6}, Ernestine Jennings⁷, Amy Gorin⁴, George D Papandonatos⁸, Alison Tovar⁹

Affiliations

¹ Department of Nutrition and Food Science, University of Rhode Island, 41 Lower College Road, Room 125, Kingston, RI, 02881, USA.
² Department of Human Development and Family Studies, and Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, USA.
³ Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
⁴ Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
⁵ Department of Human Development & Family Studies, University of Rhode Island, Kingston, RI, USA.
⁶ Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
⁷ Center for Behavioral and Preventive Medicine, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI, USA.
⁸ Center for Statistical Sciences, Brown University, Providence, RI, USA.
⁹ Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI, USA.

Abstract

There is an urgent need to create effective interventions that help parents establish a healthy diet among their children early in life, especially among low-income and ethnically and racially diverse families. U.S. children eat too few fruits, vegetables and whole grains, and too many energy dense foods, dietary behaviors associated with increased morbidity from chronic diseases. Parents play a key role in shaping children's diets. Best practices suggest that parents should involve children in food preparation, and offer, encourage and model eating a variety of healthy foods. In addition, while parents help to shape food preferences, not all children respond in the same way. Certain child appetitive traits, such as satiety responsiveness (sensitivity to internal satiety signals), food responsiveness (sensitivity to external food cues), and food fussiness may help explain some of these differences. Prior interventions to improve the diet of preschool children have not used a holistic approach that targets the home food environment, by focusing on food quality, food preparation, and positive feeding practices while also acknowledging a child's appetitive traits. This manuscript describes the rationale and design for a 6-month pilot randomized controlled trial, Strong Families Start at Home, that randomizes parents and their 2-to 5-year old children to either a home-based environmental dietary intervention or an attention-control group. The primary aim of the study is to explore the feasibility and acceptability of the intervention and evaluation and to determine the intervention's preliminary efficacy on child diet quality, feeding practices, and availability of healthy foods in the home.

Keywords: Eating behavior; Feeding practices; Nutrition; Preschool-aged.

Grants and funding

R34 HL140229/HL/NHLBI NIH HHS/United States