TY  - JOUR
AU  - Liu, Sam
AU  - Smith, Nicholas
AU  - Nuss, Kayla
AU  - Perdew, Megan
AU  - Adiputranto, Dimas
AU  - Naylor, Patti-Jean
PY  - 2022
DA  - 2022/7/5
TI  - Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention
JO  - JMIR Pediatr Parent
SP  - e36770
VL  - 5
IS  - 3
KW  - engagement
KW  - dose response
KW  - childhood obesity
KW  - web-based intervention
KW  - child
KW  - obesity
KW  - weight
KW  - web based
KW  - intervention
KW  - family
KW  - families
KW  - lifestyle
KW  - parent
KW  - parental support
KW  - healthy eating
KW  - family support
KW  - physical activity
KW  - diet
KW  - exercise
KW  - fitness
KW  - online portal
AB  - 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. 
SN  - 2561-6722
UR  - https://pediatrics.jmir.org/2022/3/e36770
UR  - https://doi.org/10.2196/36770
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35787514
DO  - 10.2196/36770
ID  - info:doi/10.2196/36770
ER  -