Mechanisms and outcomes of a very low intensity intervention to improve parental acknowledgement and understanding of childhood overweight/obesity, embedded in the National Child Measurement Programme: A sub‐study within a large cluster Randomized Controlled Trial ( MapMe2 )

Evans, Elizabeth H.; Jones, Christopher M.; Adamson, Ashley; Jones, Angela R.; Basterfield, Laura; Greca, João Paulo de Aguiar; Sermin‐Reed, Letitia; Patterson, Maddey; McSweeney, Lorraine; Dhami, Raenhha; Ells, Louisa; Gahagan, Alison; Robinson, Tomos; Shahrokhabadi, Mohadeseh Shojaei; Teare, Dawn; Tovée, Martin J.; Araújo Soares, Vera

Abstract

Objectives: Parental underdetection of child underweight and overweight/obesity may negatively affect children's longer‐term health. We examined psychological/behavioural mechanisms of a very low‐intensity intervention to improve acknowledgement and understanding of child weight after feedback from a school‐based weight monitoring programme. Design: This sub‐study was nested within a larger 3‐arm cluster‐RCT (1:1:1; N = 57,300). Parents in all groups received written postal feedback on their child's weight classification. Intervention participants received an enhanced feedback letter with computer‐generated photorealistic images depicting children of different weight classifications, and access to a website about supporting healthy weight, once (intervention one) or twice (intervention two; repeated 6 months after first ‘dose’). Methods: A quantitative process and outcome evaluation using baseline and 12‐month BMI z‐scores of an opt‐in sub‐sample of 502 children aged 4–5 and 10–11. Children completed dietary reports, used accelerometers (MVPA), and self‐reported self‐esteem; 10–11‐year‐olds also self‐reported quality of life and dietary restraint. Parents reported perceptions of child's weight classification, and their intentions, self‐efficacy, action planning and coping planning for child physical activity, dietary intake; parents of 4–5‐year‐olds reported their child's quality of life. Results: Neither intervention differentially improved parental acknowledgement or understanding of weight classification at follow‐up, although parents in all groups reported better acknowledgement after receiving feedback. The interventions did not affect behavioural/psychological determinants, weight outcomes, children's self‐esteem, dietary restraint or quality of life. Conclusions: The interventions neither improved parental acknowledgement of child weight, child BMI z‐scores and their psychological/behavioural determinants, nor worsened psycho‐social sequelae.

Citation

Evans, E. H., Jones, C. M., Adamson, A., Jones, A. R., Basterfield, L., Greca, J. P. D. A., Sermin‐Reed, L., Patterson, M., McSweeney, L., Dhami, R., Ells, L., Gahagan, A., Robinson, T., Shahrokhabadi, M. S., Teare, D., Tovée, M. J., & Araújo Soares, V. (2025). Mechanisms and outcomes of a very low intensity intervention to improve parental acknowledgement and understanding of childhood overweight/obesity, embedded in the National Child Measurement Programme: A sub‐study within a large cluster Randomized Controlled Trial ( MapMe2 ). British Journal of Health Psychology, 30(1), Article e12784. https://doi.org/10.1111/bjhp.12784

• Journal Article Type: Article
• Acceptance Date: Jan 20, 2025
• Online Publication Date: Feb 13, 2025
• Publication Date: Feb 1, 2025
• Deposit Date: Mar 12, 2025
• Publicly Available Date: Mar 12, 2025
• Journal: British Journal of Health Psychology
• Print ISSN: 1359-107X
• Electronic ISSN: 2044-8287
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 1
• Article Number: e12784
• DOI: https://doi.org/10.1111/bjhp.12784
• Keywords: child obesity, parental perceptions, weight monitoring
• Public URL: https://durham-repository.worktribe.com/output/3487619