An Intervention Embedded in a National Home

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Description: An Intervention Embedded in a National Home Visiting Program to Prevent Excess Weight Gain Debra Haire-Joshu, PhD; Cindy Schwarz, MPH, MS, RD; Rachel Tabak, PhD, RD Methods Measures 24-month pragmatic trail, with a stratified random

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slide1. An Intervention Embedded in a National Home Visiting
Program to Prevent Excess Weight Gain

Debra Haire-Joshu, PhD; Cindy Schwarz, MPH, MS, RD; Rachel Tabak, PhD, RD Methods & Measures
24-month pragmatic trail, with a stratified random design

Mothers recruited to HEALTH were located in the St. Louis region.

Intervention group received PAT + HEALTH; Usual care group received standard PAT program.

Height, weight and waist circumference of the mother was collected by trained staff.

Participants completed NHANES Dietary Screener Questionnaire, and the International Physical Activity Questionnaire to assess diet and physical activity. Background & Methods Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work and Department of Internal Medicine, Washington University, St. Louis, MO Results Conclusions Background
Clinical interventions to prevent excessive weight gain in young adult women can have significant impact in reducing obesity and incidence of type 2 diabetes mellitus.

The intensity of these trials limit their scalability to real world settings.

Parents as teachers (PAT) is a national home visiting program delivered free to nearly 170,000 families located in over 3,000 sites across all 50 states. Purpose
To embed HEALTH (Healthy Eating and Active Living Taught at Home) a lifestyle intervention for overweight and obese mothers within routine practice of PAT.

To evaluate the impact of HEALTH on overweight and obese women. Funded by: National Institutes of Health The HEALTH intervention reduced excessive weight gain and achieved clinically significant weight loss outcomes in mothers of young children.

The scalability of this embedded intervention offers the potential to prevent excessive weight gain among mothers participating in PAT programs nationally.

Future studies are needed to determine how to translate effective interventions, such as the lifestyle intervention evaluated in this study, into routine practice. At 24 months, there was a significant difference between groups in achieving a 5% weight loss (usual care vs. intervention = 10% vs. 18%)

When compared to usual care, the intervention group reported a significant reduction in sugar through beverage intake at 12 and 24 months (-1.9 vs. -3.0 tsp sugar, p <.04)

The intervention group significantly reduced their sedentary activity when compared to usual care (-1.5 hrs. vs +.6 hrs, p <.01). A significantly larger percentage of this group moved from moderate to high physical activity by 24 months (usual care 42% to 33% vs. intervention 39% to 54%, p<.05) P-value compares treatment groups on change between the specified time points using a statistical contrast within RM-ANOVA. P-values labelled pSidak are Sidak-adjusted for multiple comparisons.<br>