Search

We aimed to test main, additive, interactive effects, and feasibility of all possible combinations of six intervention components implemented for 8 weeks (Cooking/Serving Resources; Meal Delivery; Ingredient Delivery; Community Kitchen; Nutrition Education; Cooking Demonstrations). Primary outcomes were family meal frequency and preschoolers' dietary quality; secondary outcomes included family meal preparation type, meal preparation barriers, family functioning, and kitchen inventory adequacy. All possible intervention combinations were tested using a randomized factorial trial design in the first phase of a Multiphase Optimization Strategy (MOST). Feasibility was assessed via attendance, delivery logs, and satisfaction. Parent-reported data collection included: socio-demographics, frequency and type of family meals; preschooler dietary intake; perceived barriers to meal planning and preparation; assessment of family functioning; and a kitchen inventory of materials generally needed for meal preparation. Participants (n = 499) were recruited at two Head Start agencies in mid-Michigan with data collection and delivery of some intervention components in participants' homes. Promising intervention bundles were identified by evaluating pre-to post-intervention effect sizes. The combination of Cooking/Serving Resources and Meal Delivery increased family meal frequency (Cohen's d = 0.17), cooking dinner from scratch (d = 0.21), prioritization of family meals (d = 0.23), and kitchen inventory (d = 0.46) and decreased use/consumption of ready-made (d = -0.18) and fast foods (d = -0.23). Effects on diet quality were in the expected direction but effect sizes were negligible. Community Kitchen, Nutrition Education, and Cooking Demonstration showed poor feasibility due to low attendance while Ingredient Delivery was infeasible due to staffing challenges related to its labor intensity. Additionally, although not one of our pre-specified outcomes, Cooking/Serving Resources (RR = 0.74) and Meal Delivery (RR = 0.73) each decreased food insecurity. Cooking/Serving Resources combined with Meal Delivery showed promise as a strategy for increasing family meal frequency.

Objective While obesity prevention efforts emphasize the importance of healthy family meals, few studies have addressed instrumental barriers to family meals as an obesity prevention strategy. Therefore, our study objectives are to: Phase 1 - test the additive effects of six intervention components reflecting differing levels of supports for family mealtimes; identify components associated with family meals and dietary outcomes in a Screening Phase and Phase 2 - evaluate the identified components as an intervention in a randomized controlled trial in a Confirming Phase. Description Phase 1 (n = 499 children from Head Start/parents) analyses indicated that the provision of healthy meals and cookware/dinnerware sets was most robustly associated with mealtime frequency and dietary quality. In Phase 2, participants in the treatment condition receive two prepared meals delivered weekly by Meals on Wheels for 12 weeks and a comprehensive set of cookware/dinnerware. We have enrolled 58 pilot parent-child dyads (Mage parents = 31.12 years, SD = 7.97; Mage children = 4.21 years, SD = 0.52) who reflect a racially diverse, low-income sample. 75% of parents/27% of children are overweight/obese and 57% of families were food insecure at enrollment. Recruitment for an additional 250 children/parents is underway. Evaluation Given the small pilot, we utilized descriptive analyses of pre-post changes in mean scores, with Cohen's d compared to the control condition noted. The pilot intervention showed pre-post increases in the frequency of eating meals together (d = 0.13), increases in efficacy in mealtime planning (d = 0.27) and decreases in time barriers regarding meal preparation (d = -0.36). Children's body mass index z-score decreased in the treatment and control groups. Conclusion and Implications Preliminary pilot results suggest the provision of healthy, prepared meals may be related to greater frequency of family meals eaten together and improvements in perceived barriers to planning and preparing meals. At the conclusion of Phase 2, study results are expected to inform policy (e.g. where limited resources may be best allocated) and interventions (e.g. supports most effective in promoting family meals).