The Impact of a Healthy Weight Intervention Embedded in a Home-Visiting Program on Children's Weight and Mothers’ Feeding Practices

Objective: To examine whether a healthy weight intervention embedded in the Parents as Teachers (PAT) home visiting program, which was previously found to improve mothers’ body mass index (BMI) and obesity-related behaviors, changed the BMI of preschool children or maternal feeding practices. Methods: This stratified randomized trial included preschool-aged children at risk for overweight whose mothers were overweight or had obesity (n = 179). The Healthy Eating and Active Living Taught at Home (HEALTH) intervention was based on the Diabetes Prevention Program. Differences were examined using repeated-measures mixed-ANOVA models. Results: Compared with PAT usual care, the HEALTH intervention had no effect on children's BMI or maternal feeding practices. However, combined analyses showed that children's BMI percentile decreased (P =.007), BMI z-scores were maintained (P =.19), and 3 of 8 feeding practices improved over time (P <.05). Conclusions and Implications: Additional research is needed to assess the effectiveness of PAT to prevent preschool-age obesity using rigorous designs (eg, group-randomized trials) and to identify its active components. HEALTH is ready to be scaled up to prevent maternal weight gain through embedding within the national PAT program.