Objectives: Test the feasibility and additive effects of six intervention components reflecting differing levels of supports for family mealtimes and identify components associated with improved family meals and dietary outcomes in the Screening Phase. Evaluate the identified components as a bundled intervention in a randomized controlled trial (RCT) in the Confirming Phase. The target audience is parents/children enrolled in Head Start (n = 499, Screening Phase; n = 250, Confirming Phase). 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.
Description: Using the Multiphase Optimization Strategy, we tested 64 combinations of six intervention components including: Meal Delivery (MD): home delivery of family meals including recipes; Ingredient Delivery (ID): home delivery of ingredients and recipes to make family meals; Community Kitchen (CK): sessions in which families prepare meals with recipes; Didactics (NE): nutrition education with recipes; Cooking Demonstration (CD): Cooking Demonstrations with recipes; and Cookware/Flatware (CW): delivery of flatware/cookware to utilize for family meals.
Evaluation: CK, NE, and CD were poorly attended, and ID showed little change for the amount of time/cost, suggesting these four components lacked feasibility. Given small cell sizes, we utilized descriptive analyses of pre-post changes in mean scores and present Cohen's d effect sizes comparing the MD/CW to the control condition. The MD/CW combination showed pre-post increased fruit/vegetable intake (0.16), decreased sugar sweetened beverages (-0.22), decreased fast food consumption (-0.36), decreased parental low preferences for cooking (-0.20), increased use of more whole foods in meal preparation (0.24), decreased food insecurity (0.22), increased basic cookware sufficiency (0.42), and increased family functioning (0.36). However, the effect size for changes in parents/children eating together was negligible (0.05). We are partnering with Meals on Wheels as the preparation/delivery modality in evaluating MD/CW in an RCT.
Conclusions and Implications: Results will inform policy (e.g. where limited resources may be best allocated) and interventions (e.g. supports most effective in promoting family meals).
Funding: 2015-68001-23239.
