Make a Move: An Intervention to
Reduce Childhood Obesity
Kimberly Nerud, PhD, RN
International Rural Nursing Conference
Rapid City, South Dakota
July 19, 2016
Objectives
• Identify significance of need for early
interventions to reduce childhood obesity
• Define intervention process used
• Discuss results and implications for rural areas
• Identify recommendations for future studies in
rural and underserved areas
Introduction
• One-third of children in the US are obese
• Low-income children account for the largest
number
• Parents are key controllers
• Effective interventions are needed to safeguard
against the continued epidemic of childhood
obesity
Significance
• A child 2-5 years of age is considered at risk
for overweight if they are in the ≥ 85th
percentile
• Parents need guidance to become the agents of
change
• By strengthening parental understanding of
balanced nutrition and adequate physical
activity, more effective parent role-modeling
can evolve
Conceptual Framework
• Conceptual framework guiding this study was
based on the Social Cognitive Theory (SCT)
– Personal, behavioral, and environmental factors
influence one another
– People have an agency or ability to influence their own
behavior and the environment in a purposeful, goal
directed manner
– SCT assumes that learning involves not just the
acquisition of new behaviors, but also of knowledge,
cognitive skills, concepts, and values that can affect
attitudes.
Literature Review
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Socioeconomic Factors
Parental Perception
Obesity Promoting Behaviors
Parental Attitudes and Role Modeling
Community Adapted Interventions
Purpose of the Study
• The purpose of this pilot was to study the
influences of “Make a Move”, a face to face
provider-led family intervention targeting
parents with children 3-5 years of age.
Study Aims
• Aim 1: To compare the experimental
intervention to a control intervention in
producing changes on the primary outcomes
(knowledge, attitude and behavior specific to
physical activity and healthy eating).
• Aim 2: To examine the feasibility of, and
participant satisfaction with, “Make a Move”,
a family-based, childhood obesity intervention.
Hypotheses Aim 1
• 1a: The intervention group will report an increased parental knowledge of
healthy eating compared to the control group.
• 1b: The intervention group will report an increased parental knowledge of
physical activity compared to the control group.
• 1c: The intervention group will report a greater improvement in attitude
toward healthy eating compared to the control group.
• 1d: The intervention group will report a greater improvement in attitude of
physical activity compared to the control group.
• 1e: The intervention group will report a greater improvement in behavior
toward healthy eating compared to the control group.
• 1f: The intervention group will report a greater improvement in behavior of
physical activity compared to the control group.
Hypotheses Aim 2
• 2a: At least half (50%) of the experimental
group participants will complete 100% of the
intervention sessions.
• 2b: The experimental group participants
(80%) report that they were somewhat to very
satisfied with the intervention.
Method
• Design
– Randomized controlled trial - pilot study
– Intervention group and control group
– Pre- and post- test surveys
• Sample
– Head Start parent participants with children aged
3-5 years in a Mid-western area
– n = 27 participants
• (n=13) intervention group, (n=14) control group
Intervention Process
• Cultivate parent’s skill-building to improve
– Family’s healthy food choices
– Family’s physical activity level
• Protocol
– Provider-led sessions with group interaction
– Written material and demonstrations
– 4 sessions, offered weekly for 4 weeks ~ 1
hour
– Pre- and post-test data collection
“Make a Move” Intervention
• Parents were encouraged through four sessions
to:
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Increase healthy foods in home
Understand portion size
Understand energy in and energy out
Increase physical activity of family
Reduce screen time
Control Group
• Participants will be contacted personally to
complete Parent Curriculum Questionnaire
(PCQ) prior to the first intervention session
(pre-test)
• Participants will be contacted personally to
complete PCQ after the last intervention
session (post-test)
Instruments
• Parent Curriculum Questionnaire (PCQ)
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Pre- and post-test both groups
Measures variables relevant to “Make a Move”
Focused on constructs of SCT
Demographic data, 51 line items with true/false
and 1-5point scale questions
• Make a Move Satisfaction Survey
– 5 questions
– For post-test intervention group only
Hypotheses Findings
1a: Knowledge of Healthy Eating : z = 1.99, p = 0.05*
Pretest
Intervention group
Mdn = 2
Control Group
Mdn = 2
Posttest
Intervention group
Mdn = 3
Control Group
Mdn = 2.5
1b: Knowledge of Physical Activity : z = 0.44 , p = 0.66
Pretest
Intervention group
Mdn = 5
Control Group
Mdn = 5
Posttest
Intervention group
Mdn = 5
Control Group
Mdn = 5
*statistically significant
Hypotheses Findings
1c: Attitude of Healthy Eating : z = 1.14, p = 0.25
Pretest
Intervention group
Mdn = 17
Control Group
Mdn = 17
Posttest
Intervention group
Mdn = 17
Control Group
Mdn = 16.5
1d: Attitude of Physical Activity : z = 2.72, p < 0.01*
Pretest
Intervention group
Mdn = 38
Control Group
Mdn = 38
Posttest
Intervention group
Mdn = 41
Control Group
Mdn = 38
*statistically significant
Hypotheses Findings
1e: Behavior of Healthy Eating : z = 1.37, p = 0.17
Pretest
Intervention group
Mdn = 42
Control Group
Mdn = 45.5
Posttest
Intervention group
Mdn = 43
Control Group
Mdn = 45
1f: Behavior of Physical Activity : z = 2.03, p = 0.04*
Pretest
Intervention group
Mdn = 35
Control Group
Mdn = 42
Posttest
Intervention group
Mdn = 36
Control Group
Mdn = 40.5
*statistically significant
Hypotheses 2a & 2b Findings
• 2a: 77% of participants completed all 4
sessions, 23% of participants completed 3
sessions
• 2b: 100% reported mostly to very satisfied
with intervention
– 70% very satisfied
– 30% mostly satisfied
Limitations
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Study population and setting
Recruitment
Contamination
Duration of study
Retention
Nature of data
Implications for Rural Areas
• Utilization of one consistent provider
• Written and interactive material designed for
ease of use
• Populations and settings
• Supports Healthy People 2020 objectives
Recommendations
• Provider-led sessions, face-to-face and group
contact
• Retention strategies
• Measurement tools
• Self reported data
• Larger, more diverse sample
Future Research Plans
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Submitted for publication
Grant proposal submitted
Community project using 4-H youth
Collaboration with WIC program
"The physical and emotional health of an entire
generation and the economic health and security
of our nation is at stake. This isn't the kind of
problem that can be solved overnight, but with
everyone working together, it can be solved”.
Let's Move Launch Announcement, 2/9/2010