Promotion of family routines and positive parent-child interactions for obesity prevention: protocol for the 3 pillars study randomized controlled trial

Marsh, Samantha, Gerritsen, Sarah, Taylor, Rachael, Galland, Barbara, Parag, Varsha and Maddison, Ralph 2019, Promotion of family routines and positive parent-child interactions for obesity prevention: protocol for the 3 pillars study randomized controlled trial, JMIR research protocols, vol. 8, no. 4, pp. 1-13, doi: 10.2196/12792.

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Title Promotion of family routines and positive parent-child interactions for obesity prevention: protocol for the 3 pillars study randomized controlled trial
Author(s) Marsh, Samantha
Gerritsen, Sarah
Taylor, Rachael
Galland, Barbara
Parag, Varsha
Maddison, RalphORCID iD for Maddison, Ralph
Journal name JMIR research protocols
Volume number 8
Issue number 4
Article ID e12792
Start page 1
End page 13
Total pages 13
Publisher JMIR Publications
Place of publication Toronto, Ont.
Publication date 2019-04
ISSN 1929-0748
Keyword(s) New Zealand
child, preschool
family routines
health behavior
parent-child relations
pediatric obesity
randomized controlled trial
screen time
Summary Background: Childhood obesity is a challenging public health issue, with 30% of children aged 2 to 4 years classified as being overweight or obese in New Zealand. This is concerning, given that up to 90% of obese 3-year-old children are overweight or obese by the time they reach adolescence. Interventions that target this age range often fail to demonstrate long-term effectiveness and primarily focus on traditional weight-related behaviors, including diet and physical activity. However, research suggests that targeting nontraditional weight-related behaviors, such as sleep, screen time, and family meals, may be a more effective approach in this age group, given the immense challenges in changing traditional weight-related behaviors in the long term.

Objective: The aim of the proposed study was to develop and pilot the 3 Pillars Study (3PS), a 6-week program for parents of New Zealand toddlers and preschoolers aged 2 to 4 years to promote positive parent-child interactions during 3 family routines, specifically adequate sleep, regular family meals, and restricted screen time.

Methods: Screen time at the end of the 6-week program is the primary endpoint. The effects of the program on screen time, frequency of family meals, parent feeding practices, diet quality, and sleep duration will be piloted using a randomized controlled trial, with outcomes compared between the active intervention group and a wait-list control group at 6 weeks (at the end of the program) and 12 weeks (at final follow-up). We aim to recruit 50 participants (25 per arm). Eligibility criteria include parents of children aged 2 to 4 years who are currently exceeding screen use recommendations (ie, greater than 1 hour of screen time per day). The 3PS program involves a half-day workshop, run by a community worker trained to deliver the program content, and 6-week access to a study website that contains in-depth information about the program. All participants will also receive a study pack, which includes resources to encourage engagement in the 3 family routines promoted by the program. Study data will be collected in REDCap. All statistical analyses will be performed using SAS version 9.4 and have been specified a priori in a statistical analysis plan prepared by the study statistician.

Results: Trial recruitment opened in July 2018. Final follow-up was completed in December 2018, with trial findings expected to be available in early 2019.

Conclusions: Findings from this pilot study will provide relevant data to inform the design of a larger effectiveness study of the 3PS program.

Trial Registration: Australian New Zealand Clinical Trials Register ACTRN12618000823279; au/Trial/Registration/TrialReview.aspx?id=375004 (Archived by WebCite at

International Registered Report Identifier (IRRID): DERR1-10.2196/12792
Language eng
DOI 10.2196/12792
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, Samantha Marsh, Sarah Gerritsen, Rachael Taylor, Barbara Galland, Varsha Parag, Ralph Maddison
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