The Resource Information Program for Parents on Lifestyle and Education
NCT ID: NCT02330588
Last Updated: 2017-04-17
Study Results
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View full resultsBasic Information
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COMPLETED
NA
226 participants
INTERVENTIONAL
2014-10-31
2015-11-30
Brief Summary
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The following objectives of this study are to: (i) develop a web-based, brief program for parents as an educational tool to motivate parents to support healthy lifestyles in children, and access community resources and health services that can prevent childhood obesity; (ii) assess the acceptability of the program using focus groups with parents, and pediatric-focused health care professionals, trainees, and administrators; and (iii) recruit parents (n=200) in primary care and collect data at baseline and 1-month follow-up to explore if the program led to changes in parents' motivation to support their children's lifestyle habits, and families' use of resources and health services to prevent childhood obesity.
It is hypothesized that the developed screening, brief intervention, and referral to treatment (SBIRT) will (i) encourage parents of healthy weight children to seek resources to eat healthfully and be physically active to maintain their weight status (primary \[1°\] prevention), and (ii) guide parents of unhealthy weight children to access educational tools and community services to reduce their child's obesity and associated health risks (secondary \[2°\] prevention).
By providing families with tailored feedback, practical educational tools, and information on local health services, this research will help to address oft-cited barriers primary care clinicians commonly report when providing effective obesity-related health services, and encourage family self-management of obesity-related behaviors.
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Detailed Description
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Setting. This study will take place at a centrally-located Edmonton pediatric clinic housed within the Edmonton Oliver Primary Care Network (EOPCN). Primary care (PC) represents an accessible, relevant, and appropriate venue to prevent pediatric obesity because (i) PC often represents families' first point of contact with the health care system, (ii) the goals and priorities of PC clinics are well-aligned with primary and secondary prevention of chronic diseases, and (iii) patients typically access health care services throughout the life course, therefore representing a suitable environment to capture longitudinal data.
Phase I. The objective of this phase is to develop a web-based, theoretically-driven SBIRT to enhance parents' awareness, concern for, and motivation to support children's lifestyle behaviors. The SBIRT (RIPPLE; the Resource Information Program for Parents on Lifestyle and Education) will screen children of all weight statuses, deliver a brief intervention regarding children's lifestyle behaviors to parents, and provide parents with a menu of resources and community resources to facilitate the prevention of obesity in children. The intervention has been informed by the Norm Activation Model, and a survey following the intervention will test psychosocial constructs from the Theory of Planned Behavior and Health Belief Model. Parents will receive a personalized report based on their intervention responses and selected resources and services; parents will have the option to email this report to themselves.
Phase II. The objective of this phase is to refine the SBIRT using focus groups. Participants (n=30) will include parents, and pediatric-focused administrators, health care providers, research coordinators, and graduate trainees. Focus groups will query participants' overall perceptions of the program; specifically, impressions regarding likability, acceptability, satisfaction, and feasibility of incorporating the intervention into clinical practice. Focus group discussions will be transcribed in real-time using a court reporter, which will optimize transcription accuracy and ensure confidentiality. The method of Qualitative Description (QD) will be used to develop a rich and explicit description of the phenomena. QD necessitates less interpretive interference on behalf of the researcher, therefore representing an accurate and realistic embodiment of participants' discussion.
Phase III (RCT). The objective of this phase is to recruit parents (n=200) from a pediatric primary care clinic to enroll in the RCT. This double-blinded, parallel-design RCT will adhere to CONSORT guidelines. The allocation sequence will be electronically generated and blocked randomization (5 arms; block size of five) will be used to ensure equal group sizes throughout the study. Research assistants will be blinded to participants' intervention assignment and participants will not be aware if they have received the intervention or control.
Parents will be eligible for the study if they speak and read English, and have a 5 - 17 year old child who is present at the appointment with a non-urgent medical issue. Data will be collected at (i) baseline during delivery of the online RCT and (ii) 1-month follow-up to assess time-related changes in parents' psychosocial constructs (e.g., intention to change children's lifestyle behaviors; primary outcome) and families' utilization of resources and health services to facilitate healthy lifestyle behaviors (secondary outcome). Follow-up will include email delivery of a survey measure identical to that administered at baseline. Given rates of attrition tend to increase over time parents' access to the online personalized report will serve as a proxy of participation if the online survey is not completed.
Continuous variables will be described by univariate summaries; frequency distributions will be determined for categorical variables. Participant characteristics (e.g., weight status, child sex) will be examined to assess equivalence of intervention groups at baseline, and attrition tendencies across sub-groups will be examined using two-way ANOVA. Multilevel modelling will be used to assess intra- and inter-level individual and group change in the primary and secondary outcomes; this form of analysis is appropriate when observations are nested within groups and/or multiple time points. Estimates of effect sizes will be based on percent change in primary outcomes. Significance will be p\<0.05.
Significance \& Future Directions. The SBIRT is designed to encourage self-management by providing families with tailored feedback and linking them with appropriate and relevant resources to facilitate children's healthy lifestyle behaviors. Findings from this study will inform future intervention refinement and implementation into everyday clinical practice.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
QUADRUPLE
Study Groups
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Eat It! (Injunctive Feedback)
Parents are presented with two questions about portion size and sugar-sweetened beverages; answers are contrasted with injunctive feedback (i.e., Canadian guidelines).
Eat It
The SBIRT (Screening, Brief Intervention, Referral to Treatment), called RIPPLE (Resource Information Program for Parents on Lifestyle Education) was delivered on a study-designated tablet and designed to (1) screen children's weight status, (2) deliver a brief intervention\*, and (3) provide parents with the opportunity select resources and services to help prevent obesity in children.
\*Two brief questions about children's grain portion sizes and sugar sweetened beverage intake were presented.
Eat It! (Normative Feedback)
Parents are presented with two questions about portion size and sugar-sweetened beverages; answers are contrasted with normative feedback (i.e., referent data from Canadian children).
Eat It
The SBIRT (Screening, Brief Intervention, Referral to Treatment), called RIPPLE (Resource Information Program for Parents on Lifestyle Education) was delivered on a study-designated tablet and designed to (1) screen children's weight status, (2) deliver a brief intervention\*, and (3) provide parents with the opportunity select resources and services to help prevent obesity in children.
\*Two brief questions about children's grain portion sizes and sugar sweetened beverage intake were presented.
Move It! (Injunctive Feedback)
Parents are presented with two questions about screen time and moderate-to-vigorous physical activity (MVPA); answers are contrasted with injunctive feedback (i.e., Canadian guidelines).
Move It
The SBIRT (Screening, Brief Intervention, Referral to Treatment), called RIPPLE (Resource Information Program for Parents on Lifestyle Education) was delivered on a study-designated tablet and designed to (1) screen children's weight status, (2) deliver a brief intervention\*, and (3) provide parents with the opportunity select resources and services to help prevent obesity in children.
\*Two brief questions about children's moderate-to-vigorous physical activity (MVPA) and screen time were presented.
Move It! (Normative Feedback)
Parents are presented with two questions about screen time and moderate-to-vigorous physical activity (MVPA); answers are contrasted with normative feedback (i.e., referent data from Canadian children).
Move It
The SBIRT (Screening, Brief Intervention, Referral to Treatment), called RIPPLE (Resource Information Program for Parents on Lifestyle Education) was delivered on a study-designated tablet and designed to (1) screen children's weight status, (2) deliver a brief intervention\*, and (3) provide parents with the opportunity select resources and services to help prevent obesity in children.
\*Two brief questions about children's moderate-to-vigorous physical activity (MVPA) and screen time were presented.
eHealth Control
Parents randomly assigned to the control arm will include information on children's lifestyle behaviors only (no intervention questions).
eHealth Control
The eHealth Control group (1) screened children's weight status, and (2) provided parents with the opportunity select resources and services to help prevent obesity in children.
Interventions
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Eat It
The SBIRT (Screening, Brief Intervention, Referral to Treatment), called RIPPLE (Resource Information Program for Parents on Lifestyle Education) was delivered on a study-designated tablet and designed to (1) screen children's weight status, (2) deliver a brief intervention\*, and (3) provide parents with the opportunity select resources and services to help prevent obesity in children.
\*Two brief questions about children's grain portion sizes and sugar sweetened beverage intake were presented.
Move It
The SBIRT (Screening, Brief Intervention, Referral to Treatment), called RIPPLE (Resource Information Program for Parents on Lifestyle Education) was delivered on a study-designated tablet and designed to (1) screen children's weight status, (2) deliver a brief intervention\*, and (3) provide parents with the opportunity select resources and services to help prevent obesity in children.
\*Two brief questions about children's moderate-to-vigorous physical activity (MVPA) and screen time were presented.
eHealth Control
The eHealth Control group (1) screened children's weight status, and (2) provided parents with the opportunity select resources and services to help prevent obesity in children.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* parents speak and read English
Exclusion Criteria
* children attend appointment without legal guardian
* parents do not have sufficient time (15-20 minutes) to complete the intervention
ALL
Yes
Sponsors
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Alberta Innovates Health Solutions
OTHER
Canadian Institutes of Health Research (CIHR)
OTHER_GOV
Public Health Agency of Canada (PHAC)
OTHER_GOV
University of Alberta
OTHER
Responsible Party
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Principal Investigators
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Geoff DC Ball, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Alberta
Locations
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The Allin Clinic, Edmonton Oliver Primary Care Network
Edmonton, Alberta, Canada
Countries
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References
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Campbell M, Benton JM, Werk LN. Parent perceptions to promote a healthier lifestyle for their obese child. Soc Work Health Care. 2011;50(10):787-800. doi: 10.1080/00981389.2011.597316.
Avis JL, Cave AL, Donaldson S, Ellendt C, Holt NL, Jelinski S, Martz P, Maximova K, Padwal R, Wild TC, Ball GD. Working With Parents to Prevent Childhood Obesity: Protocol for a Primary Care-Based eHealth Study. JMIR Res Protoc. 2015 Mar 25;4(1):e35. doi: 10.2196/resprot.4147.
Related Links
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Study-dedicated blog to provide updates and news to research team
RCT publication (Byrne et al., 2016; Pediatric Obesity)
Other Identifiers
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RIPPLE-0613
Identifier Type: -
Identifier Source: org_study_id
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