THE RD PARENT EMPOWERMENT PROGRAM CREATES MEASURABLE CHANGE IN THE BEHAVIORS OF LOW- INCOME FAMILIES AND CHILDREN: AN INTERVENTION DESCRIPTION AND EVALUATION Presented by: Addison Ford, Dietetic Intern Hand, R.K., Birnbaum, A.S., Carter, B.J., Medrow, L., Stern, E., & Brown, K.

Outline  Background  Methods  Results  Discussion  Conclusion

Background  RD Parent Empowerment Program  Developed by the Academy of Nutrition & Dietetics Foundation in collaboration with Healthy Children, Healthy Futures  4 workshops on 8 Habits of Healthy Children & Families  Use phenomenological approach to elicit participation  Goals: Find out if participants made healthier choices for family Identify elements participants believed contributed to success

Background  8 Habits of Healthy Children and Families  1. Be physically active at least 1 hour a day  2. Spend less than 2 hours a day playing video, computer, and cell phone games or watching TV.  3. Eat a healthy breakfast every day.  4. Eat vegetables and fruits at all meals and snacks.  5. Make time for healthy family meals at home.  6. Be wise about portion size.  7. Drink water, low-fat, or fat-free milk instead of soft drinks and other sweetened beverages.  8. Ensure regular bed time for your children and teens to include at least 9 hours of sleep every night.

Methods  123 parents participated across 7 sites  All Title I schools  4 were community-based after school or early childhood education programs  Four, 1.5 to 2 hour interactive parent workshops  Minimum of 3 weeks washout between each workshop  Workshop outline  8 Habits  Shop Smart  Cook Healthy  Eat Right

Methods  Workshops included  Introductory activity  Interactive learning component  Goal setting  Healthy recipe making & tasting activity Children joined parents to participate in interactive cooking & tasting activities  Time for parents to interact with each other & leader

Methods  Evaluated using qualitative & quantitative data  Post-intervention focus groups  Pre-& post-intervention scores on Family Nutrition & Physical Activity (FNPA) survey 20-item survey, self-reported frequency of specific obeseogenic or protective behavioral & environmental factors in the home

Results  123 parents attended at least 1 workshop  Mean participation 9.7 parents per workshop per site  Focus groups  1 group only had 1 participant, in-depth interview  6 groups had 4-13 participants 5 in English, 2 in Chinese, 0 in Spanish  Participants reported making changes consistent with 8 Habits across all groups the more workshops they attended

Results  FNPA survey  80 parents completed pre-intervention  66 completed post-intervention  Significantly improved from baseline, mean 4.3 points Pre-intervention mean range: points Post-intervention mean range: points  Of those who completed post-FNPA survey 53% attended all 4 workshops 21% attended 3 of 4 26% attended 2 of 4

Discussion  No control group, hard to evaluate results  Sites selected were interested community-based organizations  Could bias results due to already being motivated  Used results from pre-FNPA to tailor messaging in various sites  Slightly different emphasis, could have different results

Discussion  Focus group participants self-selected  No Spanish-language focus group conducted  FNPA-post survey completed by those who attended majority of classes  Unable to link program attendance with pre-& post-FNPA results

Conclusion  RD-led, community-based workshops show promise  Parents liked working with children during cooking & tasting portion They found out if it was something that their child would eat  Implementing similar program for Head Start would be one way to provide nutrition education & have measurable outcome using FNPA survey

Conclusion  Short-term vs. long-term outcomes unknown  FNPA survey done just after 4 th class, don’t know if effective 6 months later  More research is needed to determine most effective intervention to change eating & health related practices in school & community settings

Citations  Hand, R.K., Birnbaum, A.S., Carter, B.J., Medrow, L., Stern, E., & Brown, K. The RD parent empowerment program creates measurable change in the behaviors of low-income families and children: an intervention description and evaluation. J Acad Nutr Diet (12):