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dose-response, head start, lifestyle, obesity, preschoolers



  1. Ling, Jiying
  2. Zahry, Nagwan R.
  3. Robbins, Lorraine B.


Background: Understanding the dose-response relationship in behavioral interventions is critical to guide future research efforts. However, only few studies have fully examined the dose-response relationship especially among children.


Objective: The aim of the study was to examine the relationships between level of participation and intervention effects.


Methods: The study used data from 39 Head Start parent-preschooler dyads participating in a 10-week lifestyle intervention. The intervention included daily center-based preschooler program, preschooler weekly letters to parents, parent meetings, and weekly Facebook-based program. Height, weight, waist circumference (WC), moderate-to-vigorous physical activity (MVPA), screen time, and fruit/vegetable intake were assessed.


Results: Preschooler program average daily attendance was 79%, and Facebook-based program average completion rate was 80%. About 49% attended all three parent meetings. Parent meeting attendance was significantly and positively related to preschoolers' vegetable intake (p = .023) and MVPA (p < .001) and parents' MVPA (p = .016). Preschooler letters were significantly and negatively related to preschoolers' screen time (p = .002) and parents' WC (p = .027) and positively correlated with parents' MVPA (p = .01). Preschooler program attendance was not significantly correlated with their body mass index ([rho] = -.31) or WC ([rho] = -.16).


Discussion: The study provides important information for designing effective interventions among low-income families. The findings imply that (a) parent-only interventions and parent-child interventions may result in similar effects, (b) future behavioral interventions should focus on the bidirectional parent-child relationship, and (c) it is important to include face-to-face contacts in lifestyle interventions. In addition, it highlights the need to examine the dose-response relationship in multicomponent lifestyle interventions.