Topic: Obesity, Nutrition/Diet
Target Population: Middle Childhood, Parents
Sector: Community-Based
This program is for children who are 8 to 12 years old and their parents.
Healthy Home Offerings via the Mealtime Environment (HOME) Plus, a community-based program, is designed to encourage families to eat healthy, balanced meals together and reduce their screen time and overall sedentary behavior.
A randomized controlled trial found no significant differences between intervention and control groups for children’s BMI z-scores, cooking skills, liking of fruits and vegetables, screen time, consumption of fruits and vegetables, fruit and vegetable availability at home, or having family dinners with green salad or fruits being served. There was a significant improvement in parental self-efficacy for identifying appropriate portion sizes in the intervention group, but no differences between groups were found for parental meal planning and cooking.
Groups of families meet at local community centers with cooking capabilities. Families receive a guidebook with session topics, strategies to promote behavior change, recipes, and local resources. Sessions consist of the following components:
Parental groups discuss barriers and strategies to initiating behavior changes, such as the following:
Children’s groups engage in hands-on nutrition education:
Parents receive phone calls from a dietitian throughout the program that use motivational interviewing and provide an opportunity to discuss behaviors and goals that complement the group session topics.
A pilot study was conducted in 44 parent/child dyads in Minnesota, and a larger study was conducted in 160 children and their parents/guardians from 2011 to 2012 in Minnesota. The extent to which the program has been used outside of these studies is unknown.
The program is delivered by registered nurses and dietitians. A standardized intervention delivery manual is provided to facilitators.
Considerations for implementing this program include locating community centers with kitchens, recruiting facilitators, understanding funds will need to be secured to rent community centers and purchase food and other materials, realizing this program requires a high level of commitment as both children and parents should attend monthly sessions for 10 months, and obtaining buy-in from participants.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email clearinghouse@psu.edu
If you are interested in implementing HOME Plus, the Clearinghouse is interested in helping you! Please call 1-877-382-9185 or email clearinghouse@psu.edu
The program includes 10-monthly sessions that last 60 to 90 minutes and 5 brief goal-setting telephone calls, and each call lasts approximately 20 minutes.
Information about implementation costs was not located.
To move HOME Plus to the Promising category on the Clearinghouse Continuum of Evidence, at least one evaluation should be performed demonstrating positive effects lasting at least one year from the beginning of the program or at least six months from program completion.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program. Phone: 1-877-382-9185 Email: clearinghouse@psu.edu
You may also contact Jayne Fulkerson by mail University of Minnesota, School of Nursing, 6-107 Weaver Densford Hall, 308 Harvard Street NE, Minneapolis, MN 55455, phone 1-612-624-4823, fax, 1-612-626-6606, email fulke001@umn.edu or contact HOME Plus by phone 1-612-624-2610 or email homeplus@umn.edu
https://nursing.umn.edu/research/research-projects/home-plus, Fulkerson et al. (2015), and Fulkerson et al. (2014).
Fulkerson, J. A., Friend, S., Flattum, C., Horning, M., Draxten, M., Neumark-Sztainer, D., ... Kubik, M. Y. (2015). Promoting healthful family meals to prevent obesity: HOME plus, a randomized controlled trial. The International Journal of Behavioral Nutrition and Physical Activity, 12(1), 154-165. https://doi.org/10.1186/s12966-015-0320-3
Fulkerson, J. A., Friend, S., Horning, M., Flattum, C., Draxten, M., Neumark-Sztainer, D., … Kubik, M. Y. (2018). Family home food environment and nutrition-related parent and child personal and behavioral outcomes of the healthy home offerings via the mealtime environment (HOME) plus program: A randomized controlled trial. Journal of the Academy of Nutrition and Dietetics, 118(2), 240-251. https://doi.org/10.1016/j.jand.2017.04.006
Fulkerson, J. A., Rydell, S., Kubik, M. Y., Lytle, L., Boutelle, K., Story, M., ... Garwick, A. (2010). Healthy home offerings via the mealtime environment (HOME): Feasibility, acceptability, and outcomes of a pilot study. Obesity, 18(n1s), S69-S74. https://doi.org/10.1038/oby.2009.434
Arcan, C., Friend, S., Flattum, C. F., Story, M., & Fulkerson, J. A. (2019). Fill “half your child's plate with fruits and vegetables”: Correlations with food-related practices and the home food environment. Appetite, 133, 77-82. https://doi.org/10.1016/j.appet.2018.10.017
Draxten, M., Flattum, C., & Fulkerson, J. (2016). An example of how to supplement goal setting to promote behavior change for families using motivational interviewing. Health Communication, 31(10), 1276-1283. https://doi.org/10.1080/10410236.2015.1062975
Draxten, M., Fulkerson, J. A., Friend, S., Flattum, C. F., & Schow, R. (2014). Parental role modeling of fruits and vegetables at meals and snacks is associated with children's adequate consumption. Appetite, 78, 1-7. https://doi.org/10.1016/j.appet.2014.02.017
Flattum, C., Draxten, M., Horning, M., Fulkerson, J. A., Neumark-Sztainer, D., Garwick, A., ... Story, M. (2015). HOME plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity. The International Journal of Behavioral Nutrition and Physical Activity, 12(1), 53-53. https://doi.org/10.1186/s12966-015-0211-7
Friend, S., Fulkerson, J. A., Neumark-Sztainer, D., Garwick, A., Flattum, C. F., & Draxten, M. (2015). Comparing childhood meal frequency to current meal frequency, routines, and expectations among parents. Journal of Family Psychology, 29(1), 136-140. https://doi.org/10.1037/fam0000046
Fulkerson, J. A., Neumark-Sztainer, D., Story, M., Gurvich, O., Kubik, M. Y., Garwick, A., & Dudovitz, B. (2014). The healthy home offerings via the mealtime environment (HOME) plus study: Design and methods. Contemporary Clinical Trials, 38(1), 59-68. https://doi.org/10.1016/j.cct.2014.01.006
Horning, M., Fulkerson, J. A., Friend, S., & Neumark-Sztainer, D. (2016). Associations among nine family dinner frequency measures and child weight, dietary, and psychosocial outcomes. Journal of the Academy of Nutrition and Dietetics, 116(6), 991-999. https://doi.org/10.1016/j.jand.2015.12.01
Loth, K. A., Friend, S., Horning, M. L., Neumark-Sztainer, D., & Fulkerson, J. A. (2016). Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes. Appetite, 107, 188-195. https://doi.org/10.1016/j.appet.2016.07.036
Loth, K., Horning, M., Friend, S., Neumark-Sztainer, D., & Fulkerson, J. (2017). An exploration of how family dinners are served and how service style is associated with dietary and weight outcomes in children. Journal of Nutrition Education and Behavior, 49(6), 513-518.e1. https://doi.org/10.1016/j.jneb.2017.03.003
Myers, M. L., Fulkerson, J. A., Friend, S. E., Horning, M. L., & Flattum, C. F. (2018). Case study: Behavior changes in the family‐focused obesity prevention HOME plus program. Public Health Nursing, 35(4), 299-306. https://doi.org/10.1111/phn.12403
