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.
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.
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).