Childhood obesity is a widespread concern for the country, especially for southern states, where the prevalence is considerably higher. For example, 39% of children in South Carolina are overweight and/or obese, which is almost double the national average (20%). For this reason, the Public Health department at the University of South Carolina has started an annual childhood obesity lecture. For the second installment, they invited Dr. Brian Saelens, a professor of pediatrics, psychiatry, and behavioral sciences at the University of Washington in Seattle. The purpose of his talk was to discuss his current research on family based care and weight management interventions.
Often based in family behavior therapy (FBT) techniques, popular interventions targeting pediatric weight management via their parents employ four common strategies: self-monitoring of food and activity, goal-setting and contingent reinforcement, environmental control, and parent modeling. These techniques and interventions have shown some success, but have not met their potential for change as they are cost and labor intensive, they are limited to certain populations, and most improvements are not long lasting after conclusion of the intervention. Dr. Saelens proposed an alternative where parents and families who have completed the intervention become peer leaders and run the intervention for other parents and families. This “pay it forward” mentality should maintain the intensity and comprehension of the intervention, reduce costs, improve reach and availability, and sustain longer lasting outcomes.
A pilot study testing the efficacy of this idea, called Parent Partnership Project, showed limited results. There was no preference among parents or kids whether professionals or other parents acted as their leaders during the intervention and it was dramatically more cost effective. However, the sample was too small to definitively show better weight related outcomes in the peer leader group over the professional-led group. Dr. Saelens and his group were able to use this pilot data to secure federal funding to implement a much larger study. Over the course of this long-term study, families will be randomly assigned to receive treatment by peers who’ve completed the program or by professionals. So far, they’ve had more than 50 families begin treatment and 10 have committed to becoming peer interventionists.
This bold new style of intervention with family weight management is brilliant for so many reasons. Above all, parents leading other parents will allow for longer lasting sustainability of weight management techniques utilized in the intervention. When parents are tasked with teaching other parents, they themselves have an accountability to continue the techniques they’re teaching in their own family. It’s analogous to how being a sleepaway camp counselor is the best training for teenagers heading off to college. They cannot fulfill their jobs of taking care of young campers without also taking care of themselves. Furthermore, for every family who completes the intervention and decides to become a peer leader, there is an exponential increase in families getting this intervention. This kind of creative thinking is what’s necessary to truly improve the obesity epidemic facing us today.
I believe that this is one beneficial way for both peer leaders and sample families to benefit from weight management interventions. Like for everything, not every intervention will work for everyone. There needs to be alternatives for people who do not thrive under specific circumstances. Overall, this seems like a good theory. Perhaps this method can be improved upon even more. Perhaps, they can continue this study for a longer period of time to allow multiple families be peer leaders at least for one other family and then bring in new families to teach at the start of the next cycle. Also, because there was no preference for leaders during intervention, this means that the peer leaders were somewhat compliant and did a great job looking after the current targeted families. This seems to be effective so far to my current knowledge. I believe it is sustainable for the most part, but how long will this cycle continue before peer leaders become burnt out?
One thing I would suggest is that since the peer parents were not professionals, how much help did they receive or were their supervisions minimal during their peer teaching?
Parents teaching other parents sounds like a great idea for building motivation and creating behavioral change. The biggest problem when counseling children or their parents is getting them to actually change their behaviors. Through motivational interviewing, we’re taught that to get people to change, they have to want to change. Interaction from peers is going to do a lot more to motivate change in others than professional opinion. However, I can see some drawbacks to this. The parents becoming leaders will be educated, but won’t have the type of education and training as a dietitian, meaning they won’t know how to give recommendations to children with different needs.
Hello, Carly! Thanks for your post! I did watch the Dr. Saelens webinar too and totally agree with you that this innovative way of doing interventions and creative thinking is what is necessary to improve the obesity epidemic! Personally, I am very interested in developing my academic project with older adults. Most adults live with and grow old among family members; however, a historical look at work in the field of family, aging and health topics reveals many studies that actually encompassed a narrower perspective (Bengston & Settersten, 2016). In my case, this webinar was particularly useful. Maybe, in the future I could take some of the family behavior therapy or family-based treatment techniques and strategies (e.g., self-monitoring of physical activity and diet, goal-setting) for implementing weight management interventions among my target population and, why not, the possibility that families become peer leaders as Dr. Saelens and his team proposed, as well as including research methods that pertain to a family level of analysis.
Reference
Bengston, V.L. & Settersten, R.A., Jr. (2016). The Handbook of Theories of Aging (3rd Ed.). New York, NY: Springer Publishing.