Use of a Novel Parental Engagement Tool in an After-school Obesity Prevention Program

Objective: To assess the impact of parental health messages delivered via two avenues on children’s reported food/drink exposure and child/parent goal setting.

Design: Pre- and post-test quasi-experimental design with two treatment groups and one historical control group.

Setting: Two elementary schools in East Tennessee.

Participants: Seventy-seven parents of participating fourth and fifth graders.

Methods: Messages were delivered to parents as the home component of an after-school program via digital home message centers (digital message group) or a more traditional method using a web-based platform and/or handouts of messages (traditional enhanced group) with results compared to a historical control with no parental engagement component. Dietary exposure was measured with child surveys, and goal card returns were tallied.

Main Outcome Measures: Pre- and post-child exposure to fruits, vegetables, whole grains, 1% and fat-free milk, healthy and unhealthy breakfast items, sugar-sweetened beverages, and solid fats and sugars; parent and child goal card returns.

Analysis: Repeated measure ANOVAs using a mixed model approach to assess changes over time and by group (significance set at 0.006) and Mann-Whitney test for goal card returns (significance set at 0.05).

Results: Total of 34 historical control group cases, 23 digital message group cases, and 20 traditional enhanced group cases. Treatment groups reported greater exposure to sugar-sweetened beverages and unhealthy breakfast (p<0.001 for both). Traditional enhanced group reported higher exposure to vegetables when compared to the historical control group (p=0.004). Both treatment groups had greater goal card returns (p<0.001). Parents in the digital message group reported viewing the health messages frequently and attempting to incorporate changes in the majority of the topic areas weekly.

Conclusions and Implications: Although outcomes were mixed, parental messages increased engagement as evidenced by the increase in returned goal cards, and added health messages were valued and frequently used by the parents. Future studies should further examine avenues of delivery for acceptability and effectiveness in increasing nutrition knowledge.