The obesity epidemic continues to be a major public health concern, with 38% of US adults and 17% of children obese. One factor that has been highlighted as a robust predictor of weight outcomes is the relative reinforcing value (RRV) of food, or how rewarding one finds eating compared to alternative activities. An emerging body of literature has built upon the observed relationship between the RRV of food and weight by hypothesizing that the promotion of alternative reinforcers, or rewarding activities that could take the place of eating, offers a novel approach to decreasing excess energy intake and combatting obesity. We aim to integrate distinct bodies of literature and fill a gap in the evidence by testing whether parenting intervention messages delivered and practiced in the context of shared activities can decrease the RRV of food by making parent-child interactions more rewarding. The ultimate goal of this research is to demonstrate that such an intervention can increase children's motivation to interact with their parent instead of eating a favorite food, demonstrating the potential for positive parent-child interactions to become an alternative source of pleasure.
The modern environment is obesity-promoting, with easy access to palatable, energy-dense foods and appealing sedentary activities. Despite this overarching environment, some individuals are able to maintain a normal weight status, suggesting that there are individual differences in susceptibility to obesity-promoting environments. The RRV of food captures individual differences in the motivation to eat by measuring how hard individuals will work for access to food versus other activities, and it has been shown to predict weight outcomes among infants, children, and adults. In a pilot study with infants, Kong, Eiden, Epstein, et al. demonstrated support for this hypothesis as providing infants and parents with access to group music classes increased infants' reinforcing values of music relative to food. Compared to other age groups, less research has been conducted on the RRV of food in preschool children. Filling this gap in the literature is important, as the preschool period is a period of drastic transitions, including extensive learning of food preferences and habits. Studies have also shown that obesity during adolescence is more likely among children who are already overweight by age 5, further highlighting the importance of innovative approaches to childhood obesity prevention prior to school entry. In the proposed study, we aim to bring together the literature on food reinforcement and the literature on parenting interventions in early childhood by promoting positive, rewarding parent-child interactions as a novel alternative reinforcer to decrease the RRV of food. Positive parenting can be defined as sensitive, responsive parenting, where parents' responses are appropriate for and contingent upon the child's cues and developmental level. This style of parenting early in life has been linked to positive cognitive and socio-emotional outcomes in adolescence and beyond. The focus of the present study is to assess the initial efficacy of the present parenting intervention, as well as its feasibility. This study will pave the way for future testing of this intervention's effects on the RRV of food and other positive developmental and health outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
33
Four video clips from the online Triple P Parenting program will be used to promote specific positive parenting practices.
There will be about 4 planned activities per week within activity boxes provided to families. The activities will be a context in which the positive parenting behaviors can be practiced. Each activity will take about 15 minutes. Families can pick each week whether they'd like their parenting practice to be embedded in reading activities, nature walks/active games, or arts and crafts. Instructions will be included with each activity, including prompts to allow the parent to apply learnings from that week's parenting video and to allow interactions to be child-led.
State University of New York at Buffalo
Buffalo, New York, United States
Child's relative reinforcing value of food versus parent-child interaction
Computer-based RRV task where child can earn portions of snacks and/or time doing an activity of choice with parent
Time frame: Week 6 (post-test)
Change in child's relative reinforcing value of food versus parent-child interaction
Computer-based RRV task where child can earn portions of snacks and/or time doing an activity of choice with parent
Time frame: Week 2 (baseline), Week 6 (post-test)
Child's maximum schedule reached for food (food reinforcement)
Computer-based RRV task where child can earn portions of snacks and/or time doing an activity of choice with parent
Time frame: Week 6 (post-test)
Change in child's maximum schedule reached for food (food reinforcement)
Computer-based RRV task where child can earn portions of snacks and/or time doing an activity of choice with parent
Time frame: Week 2 (baseline), Week 6 (post-test)
Child's maximum schedule reached for parent-child interaction
Computer-based RRV task where child can earn portions of snacks and/or time doing an activity of choice with parent
Time frame: Week 6 (post-test)
Change in child's maximum schedule reached for parent-child interaction
Computer-based RRV task where child can earn portions of snacks and/or time doing an activity of choice with parent
Time frame: Week 2 (baseline), Week 6 (post-test)
Observations of warm and sensitive parenting
Coded from parent-child interaction using Iowa Family Interaction Rating Scales. The score will be a composite of the following scales, following work by Eiden and colleagues: positive reinforcement, encourages independence, sensitive child-centered, positive mood, warmth/support, prosocial, communication, listener response, relationship quality, rater response. We will also examine relationships between the scales to examine whether the composite is appropriate. Range: 1-9, 9=more warmth/sensitive parenting
Time frame: Week 6 (post-test)
Observations of child prosocial behavior
Coded from parent-child interaction using Iowa Family Interaction Rating Scales. Scale: child prosocial behavior. Range: 1-9, 9=more prosocial behavior
Time frame: Week 6 (post-test)
Parent-reported nurturance in parenting
Comprehensive General Parenting Questionnaire. Range: 1-5, 5=more nurturance
Time frame: Week 6 (post-test)
Parent-reported structure in parenting
Comprehensive General Parenting Questionnaire. Range: 1-5, 5=more structure
Time frame: Week 6 (post-test)
Parent-reported nurturance in parenting
Comprehensive General Parenting Questionnaire. Range: 1-5, 5=more nurturance
Time frame: Week 10 (follow-up)
Parent-reported structure in parenting
Comprehensive General Parenting Questionnaire. Range: 1-5, 5=more structure
Time frame: Week 10 (follow-up)
Parent-reported parenting efficacy
Parenting Sense of Competence Questionnaire. Range: 1-6, 6=more efficacy
Time frame: Week 6 (post-test)
Parent-reported parenting efficacy
Parenting Sense of Competence Questionnaire. Range: 1-6, 6=more efficacy
Time frame: Week 10 (follow-up)
Parent-reported parenting satisfaction
Parenting Sense of Competence Questionnaire. Range: 1-6, 6=more satisfaction
Time frame: Week 6 (post-test)
Parent-reported parenting satisfaction
Parenting Sense of Competence Questionnaire. Range: 1-6, 6=more satisfaction
Time frame: Week 10 (follow-up)
Child self-regulation
Head Toes Knees Shoulders Task
Time frame: Week 6 (post-test)
Child total behavioral difficulties
Strengths and difficulties questionnaire. Range=0-40, 40=more difficulties
Time frame: Week 6 (post-test)
Child overall behavioral difficulties
Strengths and difficulties questionnaire. Range=0-40, 40=more difficulties
Time frame: Week 10 (follow-up)
Child prosocial behavior
Strengths and difficulties questionnaire. Range=0-10, 10=more prosocial behavior
Time frame: Week 6 (post-test)
Child prosocial behavior
Strengths and difficulties questionnaire. Range=0-10, 10=more prosocial behavior
Time frame: Week 10 (follow-up)
Child peer relationships problems
Strengths and difficulties questionnaire. Range=0-10, 10=more peer problems
Time frame: Week 6 (post-test)
Child peer relationships problems
Strengths and difficulties questionnaire. Range=0-10, 10=more peer problems
Time frame: Week 10 (follow-up)
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