Long-term treatment effects of the EMPOWER randomized control trial

Background. Enabling Mothers to Prevent pediatric Obesity through Web-based Education and Reciprocal determinism (EMPOWER) was a newly developed online intervention for mothers to prevent childhood obesity first implemented in 2013. Because intervention effects begin rebounding at 24 months, it is necessary to conduct long-term evaluation of programs to gauge their efficacy. The purpose of this study was to assess long-term sustainability of treatment effects linked to the EMPOWER intervention. Methods. The EMPOWER trial was a participant-blinded, active-controlled, equally-randomized (1:1), parallel-group study that targeted mothers as primary agents of change for prevention of obesity in children between 4 and 6 years of age. The experimental EMPOWER intervention was based on social cognitive theory and was evaluated against an equivalent, active control, knowledge-based intervention (Healthy Lifestyles). Impact evaluation measures were collected from participants (n = 57) at baseline, posttest, and one-month post-intervention follow-up using a previously validated instrument.  To conduct long-term evaluation, participants were contacted at 12 and 24 months post-intervention and were requested to complete the same measurement tool. Results. Variables for comparison between groups included child physical activity, fruit and vegetable consumption, sugar-free beverage intake, and screen time. Social cognitive theory maternal-facilitated constructs of environment, emotional coping, expectations, self-control, and self-efficacy hypothesized to mediate changes in the child behaviors were also collected. Data were modeled using repeated measures multivariate analysis of variance (RM MANOVA). Conclusions. Online family-and-home-based interventions are efficacious for improving behaviors posited to reduce risk for childhood obesity. Follow-up booster sessions with participants may assist in maintaining treatment effects.