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The effectiveness of lifestyle triple P in the Netherlands: A randomized controlled trial

Author: Gerards, S.M.P.L. · Dagnelie, P.C. · Gubbels, J.S. · Buuren, S. van · Hamers, F.J.M. · Jansen, M.W.J. · Goot, O.H.M. van der · Vries, N.K. de · Sanders, M.R. · Kremers, S.P.J.
Source:PLoS ONE, 4, 10, e122240
Identifier: 525589
doi: doi:10.1371/journal.pone.0122240
Keywords: Health · Body composition · Body mass · Child · Child nutrition · Child parent relation · Controlled study · Dietary intake · Family counseling · Female · Fluid intake · Food intake · Group therapy · Human · Major clinical study · Male · Netherlands · Obesity · Outcome assessment · Parallel design · Parent counseling · Parental attitude · Physical activity · Psychological aspect · Randomized controlled trial · Satisfaction · Sedentary lifestyle · Self concept · Skinfold thickness · Soft drink · Telemedicine · Waist circumference · Healthy for Life · Healthy Living · Life · LS - Life Style · ELSS - Earth, Life and Social Sciences


Introduction Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands. Method We used a parallel randomized controlled design to test the effectiveness of the intervention. In total, 86 child-parent triads (children 4-8 years old, overweight or obese) were recruited and randomly assigned (allocation ratio 1:1) to the Lifestyle Triple P intervention or the control condition. Parents in the intervention condition received a 14-week intervention consisting of ten 90-minute group sessions and four individual telephone sessions. Primary outcome measure was the children' s body composition (BMI z-scores, waist circumference and skinfolds). The research assistant who performed the measurements was blinded for group assignment. Secondary outcome measures were the children's dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, and parental self-efficacy. Outcome measures were assessed at baseline and 4 months (shortterm) and 12 months (long-term) after baseline. Multilevel multiple regression analyses were conducted to determine the effect of the intervention on primary and secondary outcome measures. Results No intervention effects were found on children's body composition. Analyses of secondary outcomes showed positive short-term intervention effects on children's soft-drink consumption and parental responsibility regarding physical activity, encouragement to eat, psychological control, and efficacy and satisfaction with parenting. Longer-term intervention effects were found on parent 's report of children's time spent on sedentary behavior and playing outside, parental monitoring food intake, and responsibility regarding nutrition. Conclusion Although the Lifestyle Triple P intervention showed positive effects on some parent reported child behaviors and parenting measures, no effects were visible on children's body composition or objectively measured physical activity. Several adjustments of the intervention content are recommended, for example including a booster session. © 2015 Gerards et al.