An RCT for Overweight and Obesity in Preschoolers from Three Countries: The STOP Project

• Published in: Obesity (Silver Spring, Md.) Md.), 2023-11, Vol.31, p.193-193
• Main Authors: Nowicka, Paulina, Ek, Anna, Chirita-Emandi, Adela, Tur, Joseph, Nordin, Karin, Bouzas, Christina, Argelich, Emma, Serban, Costela Lacrimioara, Iulia, Jurca-Simina, Brissman, Markus, Martinez, Alfredo, Lof, Marie, Saez, Marc
• Format: Article
• Language: English
• Subjects: Eating behavior; Families & family life; Obesity; Overweight; Questionnaires; Weight control
• ISSN: 1930-7381; 1930-739X

Background: According to the recent guidelines by the American Academy of Pediatrics, treatment of obesity should start at the age of 2 years. Still, few studies had assessed the effects of treatment in this age group. The aim of this multicountry RCT was to assess the tiveness of a support program followed by a mHealth application in families with preschoolers. Methods: 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden and their parents were randomized to the More and Less (ML) parent group (PG) or to standard treatment (ST). The 10-week ML program focused on parenting practices followed by a the MINISTOP app for 6-months supporting a healthy lifestyle. The primary outcome: child weight status (BMI SDS) after 9-months. Secondary outcomes: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire) and the acceptance of the overweight and obesity management in young children (semistructured interviews). Results: A total of 304 2-to 6-year-old children and their families participated in the study. Mean (SD) age of the children was 5.0 (1.2) years, mean BMI SDS was 3.0 (1.0), 64% were girls, 53% had severe obesity, 23% obesity, and 24% overweight. At 9-months, a larger decrease in BMI SDS was seen in PG (-0.35, SD 0.48) compared to ST (-0.11, SD 0.43) (p < 0.001). The dropout was 19%. The delivery of the ML program was appreciated, and the content well accepted by families and group leaders in the three countries. The MINISTOP app worked best in Sweden where 75.5% of families used the app, in Spain 64.4%, while in Romania 28.6% used the app. Conclusions: The culturally adapted intervention (ML parent program and MINISTOP app) was accepted by families in all three countries: Romania, Spain, and Sweden. Our preliminary results show that the ML program was effective in improving weight status in young children in all countries.