Healthy Children, Healthy Families (HCHF): Parents making a difference!
We performed a cluster-randomized controlled trial to test the efficacy of an integrated nutrition and parenting curriculum teaching responsive parenting and strategies for promoting healthy diets and physical activity for children aged 3-1 years. “Healthy Children, Healthy Families: Parents making a difference!” is a program implemented through Cornell Cooperative Extension to improve child nutrition and maintain healthy child weights in low income families. Program-based evidence indicates effectiveness, but this cluster-randomized trial in New York City provides an opportunity for a rigorous evaluation of impact. In addition, we are conducting a qualitative sub-study to assess participant perspectives on value of program and behavior change experiences.
Other work related to HCHF includes development of the HCHF curriculum (available here), a tool for assessing behavior change in the program, and translation and testing of this tool in Spanish.
A previous study followed up HCHF program participants to examine their subsequent experiences with trying and adopting new parenting and child feeding behaviors. This study measured parenting and feeding styles as well as psychosocial, economic, health, and environmental barriers to adopting recommended parenting and child feeding practices. An important contribution of this paper was adaptation of the trials of improved practices methodology to understand barriers and facilitators of behavior change in the US context, focused on older children with more diverse diets (than the usual application to diets of 0-2 year olds in low-income countries), and to parenting as well as nutrition behaviors. Parents were most motivated to increase children’s vegetable intake and reduce sweetened beverages and reluctant to reduce serving sizes. Their preferred parenting practices to support improved child diets were role-modelling; shaping home environments, involving children in decisions about meals, and providing positive feedback. Information on parents’ willingness and ability to try recommended practices at home over several months of follow-up provided valuable guidance for childhood obesity prevention programs.
Research Team: Kate Dickin, Jamie Dollahite, Tisa Hill, Carol Parker, Michelle Scott-Pierce
Funding: Funded by Federal Formula Funds, USDA/Cornell University Agricultural Experiment Station (on-going).
Dickin KL, Larios F, Parra PA. Cognitive interviewing to enhance comprehension and accuracy of responses to a Spanish-language nutrition program evaluation tool. Journal of Nutrition Education and Behavior 2015; 47(5): 465-471.
Dickin KL and Seim, G. Adapting the Trials of Improved Practices approach to explore the acceptability and feasibility of nutrition and parenting recommendations: What works for low-income families? Maternal and Child Nutrition 2015; 11:897-914.
Dickin KL, Hill TF, and Dollahite JS. Practice-based evidence of effectiveness in an integrated nutrition and parenting education intervention for low-income parents. Journal of the Academy of Nutrition and Dietetics 2013.
Dickin KL, Lent M, Lu AH, Sequeira J, Dollahite JS. Developing a measure of behavior change in a program to help low-income parents prevent unhealthy weight gain in children. Journal of Nutrition Education and Behavior 2012; 44:12-21.
Lent M, Hill TF, Dollahite JS, Wolfe W, Dickin KL. Healthy Children, Healthy Families: Parents Making a Difference! A curriculum integrating key nutrition, physical activity, and parenting practices to help prevent childhood obesity. Journal of Nutrition Education and Behavior 2012; 44:90-92.