Background
CVH, CVD
CVD, CHILDHOOD OBESITY, CARDIOVASCULAR DISEASE
Cardiovascular disease (CVD) is a highly prevalent public health problem [First, over two decades of observational cross-sectional and longitudinal research shows that family meal quantity (i.e., frequency) is associated with child health including higher diet quality, lower prevalence of unhealthy weight control behaviors, better psychosocial health, and reduced risk for childhood obesity—although weight status findings are mixed [Prior interventions to increase child CVH have not been anchored around a specific family context/routine such as family meals. Instead, interventions often take a “kitchen sink approach” targeting multiple home environment factors (e.g., eating, physical activity, sedentary behavior, parenting) across multiple contexts (i.e., home, school, daycare). These interventions have had limited success [Second, some observational studies have shown the need to examine family meal “quality” (i.e., dietary intake, interpersonal atmosphere), in addition to family meal quantity, to better understand key protective factors of family meals [Additionally, studies have identified barriers to carrying out family meal routines such as busy schedules, parental stress, lack of food prep/cooking skills, and child behaviors (e.g., picky eating) [Third, research shows that providing immediate feedback on behavior (i.e., ecological momentary intervention (EMI), video feedback) within a specific context (e.g., family meals) results in more behavior change over time [Ecological momentary intervention (EMI), or mobile health (mHealth), uses smartphones to send text messages to participants to intervene on behaviors in real-time as they unfold, moment-by-moment, over time and across contexts [Fourth, interventions utilizing community health workers (CHWs) who can meet participants “where they are at,” both with regard to readiness for change and in their own environment (i.e., home visiting) are associated with better outcomes [The main aim of the Hypothesis 1: BMI percentile (%ile) and neck circumference will decrease and diet quality will increase in children in Arm 3 compared to children in Arms 1 or 2.Hypothesis 2: Family meal quantity and quality will increase, controlling food parenting practices (e.g., restriction) will decrease, and parent coping skills will increase in parents in Arm 3 compared to parents in Arms 1 or 2.Hypothesis 3: BMI %ile will decrease in siblings in Arm 3 compared to siblings in Arms 1 or 2.Family Matters Intervention Study