Impact evaluation of the enabling mothers to prevent pediatric obesity through web-based education and reciprocal determinism (EMPOWER) intervention

Background: The purpose of this study was to evaluate the efficacy of the EMPOWER intervention; a Web-based, social cognitive theory (SCT) driven, mother-centered program for prevention of pediatric obesity. Methods: The eight-week trial utilized a randomized experimental design to test the efficacy of the intervention. Statistically, a repeated measures one-between, one-within subjects design was employed. The treatments were delivered to two cohorts randomly assigned to receive either the EMPOWER (experimental) or Healthy Lifestyles Program (control) protocol (n = 50; α = 0.05, 1-β = 0.80, ρ = 0.20). The primary independent variable under investigation was the intervention assignment. This was a fixed, categorical variable with two levels: EMPOWER intervention and Healthy Lifestyles intervention. The second independent variable in the study was time (within-subjects effect). This was also be a fixed, categorical variable with three levels: (1) baseline; (2) post-intervention (4 weeks); and (3) one-month, post-intervention follow-up (8 weeks from baseline). Results: Key study dependent variables included four protective child behaviors (physical activity behavior, fruit and vegetable consumption behavior, sugar-free beverage consumption behavior, and screen time behavior) and maternal-mediated constructs of SCT (environment, emotional coping, expectations, self-control, and self-efficacy). Dependent variables were tested using multivariate and univariate analysis of variance tests. Significant maternal-mediated SCT predictors were regressed on protective child behaviors at pretest to posttest, posttest to follow-up, and pretest to follow-up. Conclusion: The home and family environment is an influential antecedent of pediatric obesity. Social cognitive theory is a useful framework for modifying family and home-based determinants of pediatric obesity.