The intervention aimed to help families adopt healthy eating and physical activity habits through 16 core sessions conducted over 6-9 months. The sessions were led by registered dietitians and covered topics such as:
Nutrition fundamentals: The basics of healthy eating were discussed based on the U.S. Department of Agriculture’s MyPlate guidelines. Families learned about proper portion sizes, reading food labels, understanding calories and nutrients, making smart substitutions, and planning meals/snacks around the major food groups. Emphasis was placed on choosing whole, minimally processed foods.
Meal planning: Skills were taught for budget-friendly weekly meal planning that incorporates more fruits/veggies, lean proteins, whole grains and dairy. Families practiced weekly meal planning as a group activity.
Progressive goal setting: Families set small, graduated goals to work on between sessions, such as adding a fruit or vegetable to one meal per day or incorporating 30 minutes of activity 3 times per week. Goals focused on behavior changes rather than weight or appearance to reduce pressure.
Behavior modification techniques: Cognitive restructuring, stimulus control, problem solving, contingency management/reinforcement, and relapse prevention strategies were discussed. Families learned how habits form and practical techniques to modify eating/activity behaviors.
Parenting skills: Parents learned responsive feeding techniques based on child hunger/fullness cues instead of pressuring children to eat. Strategies included child involvement in shopping/preparation, modeling of behaviors, positive reinforcement of eating fruits/veggies or playing outside. Authoritative discipline techniques emphasizing healthy limits and choices were discussed.
Portion sizes: Interactive exercises using plates, boxes and photos taught accurate portion sizes for grains, proteins and especially energy-dense/added sugar foods. Portion distortion was addressed.
Dining out: Skills to make healthier choices when eating away from home at restaurants, fast food or social events were covered. Modifying common recipes, asking for sauces/dressings on the side and budget-friendly restaurant swaps were discussed.
Physical activity: Following evidenced-based recommendations, families learned about the health benefits of reducing small screen time activities like TV/video games and replacing them with fun interactive games and sports anytime activities. Walking programs were started.
Stress and emotional eating: Stress management techniques like deep breathing, journaling and relaxation were taught. Coping strategies other than eating were discussed to manage emotions. The difference between physical and emotional hunger was highlighted.
Support systems and community resources: Strategies empowered families to utilize social support systems through pairing with other participant families. Food access and physical activity resources in their community were identified to encourage long-term sustainability.
Weekly grocery store tours: Led by a registered dietitian, families experienced grocery stores together to locate lower calorie options and healthier alternatives to frequent buys. Sales flyers were evaluated through a nutrition lens.
Cooking demonstrations: Professionally-led cooking classes introduced families to quick, low-cost and delicious recipes meeting intervention guidelines. Tastings encouraged trying new fruits/veggies/seasonings.
Goal setting review: Progress towards individualized behavior change goals set in early sessions were evaluated at each class through group discussion. Additional strategies to address barriers provided individualized troubleshooting. Supportive accountability to work towards lifestyle changes as a family unit was cultivated.
The multi-component intervention focused on intensive behavior modification through nutrition education, parenting skills and hands-on activities to equip families with sustainable skills and community resources to adopt healthier lifestyles long-term. Evaluation showed this comprehensive approach was significantly more effective at producing behavior changes and weight outcomes compared to standard recommendations alone.