@Article{info:doi/10.2196/36770,
author="Liu, Sam
and Smith, Nicholas
and Nuss, Kayla
and Perdew, Megan
and Adiputranto, Dimas
and Naylor, Patti-Jean",
title="Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention",
journal="JMIR Pediatr Parent",
year="2022",
month="Jul",
day="5",
volume="5",
number="3",
pages="e36770",
keywords="engagement; dose response; childhood obesity; web-based intervention; child; obesity; weight; web based; intervention; family; families; lifestyle; parent; parental support; healthy eating; family support; physical activity; diet; exercise; fitness; online portal",
abstract="Background: The Early Intervention Program (EIP) was a 10-week, blended, in-person and online lifestyle intervention for families with children who were off the healthy weight trajectory. The engagement pattern and the dose response of EIP have not been examined. Objective: The aims of this paper are to examine families' engagement patterns with the EIP and to evaluate the dose-response relationship between EIP engagement patterns and physical activity and healthy eating--related outcomes at 10 weeks. Methods: Families with children (8-12 years old) who are off the healthy weight trajectory (child BMI ≥85th percentile for age and sex) were recruited. Pre- and postintervention questionnaires assessed child lifestyle behaviors, parental support behaviors, family lifestyle habits, as well as parental physical activity and healthy-eating identity. Hierarchical cluster analysis of both in-person and online components was used to classify engagement patterns. Regression analysis assessed differences in outcomes by engagement groups. Results: Two distinct clusters of engagement groups were identified (N=66), which were in-person (IP; n=40, 61{\%}) and in-person + online (IP+; n=26, 39{\%}) engagement. Relative to the IP group at week 10, IP+ showed a greater child moderate-to-vigorous physical activity level (1.53, SD 0.56; P=.008), child physical activity confidence (1.04, SD 0.37; P=.007), parental support for child physical activity (5.54, SD 2.57; P=.04) and healthy eating (2.43, SD 1.16; P=.04), family habits for physical activity (3.02, SD 1.50; P=.049) and healthy eating (3.95, SD 1.84; P=.04), and parental identity for physical activity (2.82, SD 1.19; P=.02). Conclusions: The online EIP portal complemented the in-person sessions. Additional engagement with the portal was associated with greater improvements in child physical activity and parental support behaviors, habits, and identity for physical activity. ",
issn="2561-6722",
doi="10.2196/36770",
url="https://pediatrics.jmir.org/2022/3/e36770",
url="https://doi.org/10.2196/36770",
url="http://www.ncbi.nlm.nih.gov/pubmed/35787514"
}