Efficacy of a Family-Centered Obesity Intervention Among Children and Their Mothers in Oman.

Background: Children in Oman are at high-risk for developing overweight and obesity and pre-diabetes, type 2 diabetes, and cardiovascular disease later in life. Mothers play a central role in shaping their children?s health behaviors evidenced by a strong correlation between children?s health behaviors and overweight or obesity in mothers. Childhood obesity is relatively new in Oman and has not to date been adequately examined. Prior descriptive and correlational studies indicated a family influence on children?s BMI z-scores, nutrition intake, and physical activity patterns. It is imperative to examine childhood obesity interventions from a cultural perceptive. Purpose: This proposed study aims to translate and examine the initial efficacy of a well-developed intervention among the Omani population. It targets mothers and their school age children. Subjects and Methods: This is a two-phase study. In phase 1, we plan to translate the intervention into Arabic and feasibility test it with 10 mothers and their children age six to ten years old and further culturally tailor the intervention. In phase 2, we will conduct a randomized controlled pilot study with 25 mothers in the intervention group and 25 mothers in the wait-listed control group and further culturally refine the intervention. We will test the initial efficacy of the intervention on the children?s primary outcomes (adiposity and weight) from Time 1 (T1, Baseline) to Time 2 (T2, 4 months and after the intensive 16-week mother?s intervention), to Time 3 (T3, 8 months and after 4 monthly meetings), to Time 4 (T4, 12 months and after 4 months on their own without contact with the study staff). Concurrently, we will test the initial efficacy on mother?s primary outcomes (adiposity and weight) and secondary outcomes (health behaviors [nutrition and physical activity] and self-efficacy from T1 (Baseline) to T2 (4 months and after the intensive 16-week mother?s intervention), to T3 (8 months and after 4 monthly meetings), to T4 (12 months and after 4 months on their own without contact with the study staff). For analysis, we will calculate means, standard deviations, medians and ranges for each continuous variable and tabulate frequencies and percentages for each categorical variable. We will use an intent-to-treat analysis to include all participants according to their initial randomized assignment. Significance: In Oman, childhood overweight and obesity continues to escalate. It is imperative to manage the problem through a cultural lens. The Omani government is aware of the escalating childhood obesity problem and is encouraging the development of programs to prevent overweight and obesity in children.17 To date, there have been few research studies in Oman that have promoted the nutrition intake and physical activity behaviors in middle age Omani children. This study is significant because overweight and obesity is increasing in Oman which will lead to chronic diseases such as prediabetes, type 2 diabetes, and cardiovascular diseases later in life for both mothers and children. Taking a 16-week intervention that has been efficacy tested in English and Spanish and translating it into Arabic and culturally tailoring it for mothers in Oman may decrease future chronic disease.