NOURISH-T: Targeting caregivers to improve health behaviors in pediatric cancer survivors with obesity

Marilyn Stern; Jennifer Bleck; Linda J Ewing; Esther Davila; Courtney Lynn; Gregory Hale; Suzanne Mazzeo

doi:10.1002/pbc.26941

NOURISH-T: Targeting caregivers to improve health behaviors in pediatric cancer survivors with obesity

Pediatr Blood Cancer. 2018 May;65(5):e26941. doi: 10.1002/pbc.26941. Epub 2018 Jan 19.

Authors

Marilyn Stern¹, Jennifer Bleck¹, Linda J Ewing², Esther Davila³, Courtney Lynn⁴, Gregory Hale⁵, Suzanne Mazzeo^{6

7}

Affiliations

¹ Department of Child and Family Studies, University of South Florida, Tampa, Florida.
² Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
³ Department of Psychology, University of South Florida, Tampa, Florida.
⁴ Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida.
⁵ All Children's Hospital/Johns Hopkins Medical Center, St. Petersburg, Florida.
⁶ Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
⁷ Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia.

Abstract

Background: Obesity rates in pediatric cancer survivors (PCS) are alarmingly high. Although healthy lifestyle changes may prevent future health complications, promoting healthy behaviors in PCS is challenging, and few interventions have successfully addressed this issue.

Procedure: This randomized control trial evaluated the feasibility and preliminary effectiveness of a parent-focused six-session intervention, NOURISH-T (Nourishing Our Understanding of Role Modeling to Improve Support and Health for Healthy Transitions), compared with enhanced usual care (EUC) on the outcomes of caregiver and PCS anthropometric measurements, eating behaviors, and physical activity. Behavioral and self-report assessments of caregivers and PCS in both conditions were conducted at baseline, postintervention, and at a 4-month follow-up.

Results: In comparison to no change among EUC caregivers, NOURISH-T caregivers showed small yet significant decreases from baseline through follow-up on BMI, waist-hip ratio, and total daily caloric intake. However, there was no change with regard to daily fat and sugar intake. NOURISH-T caregivers also showed positive changes in their child feeding behaviors, including decreases in pressuring their child to eat and restricting their child's eating and increased eating together as a family. Similarly, decreases in BMI percentile, waist-hip ratio, and sugary beverage consumption were found for NOURISH-T PCS from baseline to postintervention. NOURISH-T PCS also significantly increased their daily steps, whereas EUC PCS decreased their daily steps.

Conclusions: Results suggest that an intervention targeting parents is feasible and demonstrates preliminary effectiveness. NOURISH-T showed a longer term effect on caregivers, and, although shorter term effect, a positive impact on the PCS themselves. Implications for ways to improve NOURISH-T as an intervention for increasing healthy behaviors of PCS are discussed.

Trial registration: ClinicalTrials.gov NCT02815982.

Keywords: parent training; pediatric cancer; pediatric obesity; randomized clinical.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Adult
Cancer Survivors / psychology*
Caregivers / education*
Child
Child, Preschool
Feasibility Studies
Female
Follow-Up Studies
Health Behavior*
Humans
Male
Neoplasms / physiopathology*
Parents / education*
Pediatric Obesity / therapy*
Surveys and Questionnaires

Associated data

ClinicalTrials.gov/NCT02815982

Grants and funding

R21 CA167259/CA/NCI NIH HHS/United States