Effectiveness of mobile application on changing weight, healthy eating habits, and quality of life in children and adolescents with obesity: a randomized controlled trial

Background A technology-based intervention, such as a mobile application, was a growing interest and potentially effective modality for treating obesity. The study aimed to evaluate the effectiveness of the OBEST, a new mobile/tablet-based application in reducing weight and encouraging healthy eating behaviors and quality of life in children with obesity. The application could assist healthcare professionals to treat children and adolescents with obesity. Methods A randomized controlled trial was conducted in the hospital and school settings in Chiang Mai, Thailand. Seventy-seven children and adolescents with obesity were randomized into two groups; one received standard care combined with the OBEST application, and the other received only standard care. The outcomes were changes in weight, healthy eating behaviors, and quality of life assessed by the Pediatric Quality of Life Inventory (PedsQL) from baseline to six-month follow-up between the two groups. Results The results showed that the intervention group reduced more body mass index (BMI) and had a higher number of participants engaging in healthy eating behaviors than the standard care group but did not reach a statistically significant level, except for less frequent consumption of fast food. The participants in the intervention group had 4.5 times higher odds of decreased engaging in fast-food consumption than the standard care group at 6 months follow-up (odds ratio, 4.5 [95% CI, 1.41 to 14.35]). There were no statistically significant changes in PedsQL scores over 6 months in between groups. Conclusions The current study was unable to detect a significant effect of the OBEST application as an adjunct tool to the standard treatment on reducing weight in obese children and adolescents. However, the mobile application might help to increase engaging in healthy eating behaviors. Further studies with a larger sample are needed to confirm our findings. Trial registration The trial was retrospectively registered at the Thai Clinical Trials Registry (trial registration number: TCTR20200604008, on June 4, 2020).

DETERMINANTS OF SCIENCE TEACHERS’ HEALTHY EATING BEHAVIORS: COMBINING HEALTH BELIEF MODEL AND THEORY OF PLANNED BEHAVIOR

This study was conducted to provide a comprehensive understanding of determinants of science teachers’ healthy eating intentions and behaviors by combining the health belief model and the theory of planned behavior into one conceptual framework and considering the mediating impact of attitude and intention on behavior. This study was conducted based on cross sectional study design between November 2019 and February 2020. A total of 13 hypotheses were tested and data collected from 563 science teachers in Turkey were analyzed using structural equation modeling. The results of the study showed that the proposed model explained the variance in intention and behavior at a more satisfactory level than existing theories. The results also revealed that all of the hypotheses were supported. In addition, the mediating role of attitude and intention in understanding science teachers’ healthy eating behaviors was identified. The study can provide important implications for education stakeholders, curriculum developers and science educators. Keywords: health belief model, healthy eating behavior, science education, theory of planned behavior

Assessment of Cooking Matters Facebook Platform to Promote Healthy Eating Behaviors among Low-Income Caregivers of Young Children in the United States: A Pilot Study

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes pre- and post-following CM Facebook. A binary indicator was developed to measure whether the outcomes were improved (1 = Improved; 0 = Not improved). Multi-variable logistic regressions were applied to examine the relationship between whether the outcome was improved with reference to the baseline socio-demographics. No significant differences were detected between pre and post outcomes overall (p > 0.05), except improvement in feeding healthy meals within the budget available (p < 0.05). However, improvement in select outcomes was more significant in men and single-parent households. The CM Facebook page could be an important platform to influence low-income caregivers of young children.

Promoting Healthy Eating Behaviors by Incentivizing Exploration of Healthy Alternatives

Incentive-based intervention programs aimed at promoting healthy eating behaviors usually focus on incentivizing repeating the desired behavior. Unfortunately, even when effective, these interventions are often short-lived and do not lead to a lasting behavioral change. We present a new type of intervention program focused on incentivizing exploration of new healthy alternatives rather than incentivizing repeated healthy behaviors. This intervention aims to help participants find long-lasting “personal treasures” —new foods that are both healthy and tasty for them. Our field study included a final sample of 48 students with low or medium daily consumption of fresh salads. Participants in the control group received a fixed payment for completing the program, while the participants in the incentivized exploration group received a lower fixed fee for completing the task and a bonus for each new salad they tried. Results show that participants in the incentivized exploration group reported eating more salads even 1 year after the program ended compared to the participants in the control group. Though preliminary, our results paint a promising picture for the successful application of incentivizing exploration interventions to promote healthy lifestyle.

Childcare Staff Feeding Practices Associations With Children's Willingness to Try New Foods

Objectives To examine the associations between childcare staff feeding practices and preschool children's willingness to try new foods (WTNF). Methods Participants included children (n = 460), ages 3–5 years, and childcare staff (n = 91) recruited from childcare centers in Maryland participating in baseline assessment of a randomized controlled trial to evaluate strategies to promote the development of healthy eating behaviors. Staff feeding practices were measured using the Comprehensive Feeding Practices Questionnaire (CFPQ) adapted to the childcare setting. Children's WTNF was evaluated by offering 6 novel and 3 familiar foods during a food tasting activity administered in the childcare center. Confirmatory and exploratory factor analyses were used to evaluate the factor structure of the adapted version of the CFPQ, and to identify modified factor structures. Logistic regressions assessed the association between childcare staff feeding practices (i.e., average staff feeding factor scores in a classroom) and children's WTNF (dichotomized as high: tried ≥ 3 novel foods vs. low: tried &lt; 3 novel foods), adjusting for child sex and age and clustering in the childcare center. Results A revised 7-factor, 32-item model, including indulgent, restriction for health, monitoring, pressure, environment, healthy eating guidance, and encourage balance and variety, was identified to assess childcare staff feeding practices. Children under the care of staff members who reported more frequent use of indulgent feeding practices in the classroom had 2.13 (95% CI: 1.04 - 4.37) greater odds of demonstrating high WTNF compared to children under the care of staff members who reported lower use of this feeding practice, with no associations among other feeding practices. Conclusions Childcare staff use of food to regulate children's behaviors and/or emotions (i.e., indulgent feeding) was related to children's greater willingness to try new foods in childcare settings. Understanding the mechanisms underlying childcare staff-child feeding can inform interventions to promote healthy eating behaviors among young children. Longitudinal studies are needed to determine the direction of effect between staff's indulgent feeding practices and children's willingness to try new foods. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases.