The main objective of the LifeStyle project was to implement and evaluate the effects of the Group Lifestyle Triple P (GLTP) program, an evidence-based program for parents of overweight/obese children. To achieve this goal, the following activities were developed:
1) Contracting with Triple P International, the enterprise responsible for the dissemination of the positive parenting programs that are part of the Triple P System. This contract included (1) the translation into European Portuguese and the edition of the materials required to implement the program and the parent manual, (2) the acquisition of the parent handbooks, (3) the training and accreditation of the professionals and researchers who implemented the program, and (4) receiving technical advice on the implementation of the research project by a Triple P expert consultant.
2) Translation of the chapter of the Facilitator's Manual that describes the delivery of the group and individual sessions with parents (14 sessions).
3) Recruitment of healthcare providers (physicians, nurses, therapists, nutritionists, and psychologists) from the Administração Regional de Saúde do Norte (ARS Norte) to participate in the GLTP training. The training took place in May 2019 and the accreditation in July 2019. Preparation sessions were organized for the accreditation of these professionals. These professionals will be able to implement the program in health care community-based services, allowing the dissemination and sustainability of the intervention after the completion of the RCT.
4) Permissions to conduct the project were obtained from different committees in different institutions: Ethics Committee and the Department of Teaching, Training and Research of the Centro Materno Infantil do Norte (CMIN) at the University Hospital Center of Porto, and the Ethics Committee of the Regional Health Administration of the North (ARS Norte). A positive appraisal was also obtained from the Data Protection Unit of the University of Porto and subsequent authorization from the Rector of the University of Porto.
5) Recruitment of families from those enrolled at the Consult of Nutritional Pediatric Changes at the CMIN, run by the pediatricians who are part of the research team of this project. Parents who met the inclusion requirements were informed about the research project and the GLTP program and signed an informed consent form. Recruitment was initially conducted face-to-face in the hospital but was discontinued at the time of the state of emergency determined by the Portuguese government due to COVID-19. The recruitment was made available again four months later, in July 2020, but since then, as per the Hospital's request, conducted remotely through videoconferencing.
6) Revision and extension of the evaluation protocol foreseen at the time of the project application, to include: (1) a food intake diary (to be completed by the parents for 3 days) and a food frequency questionnaire, (2) physical activity assessment using an accelerometer (worn by the children for 4 days) and recording of daily frequency of physical activity (during the 4 days the accelerometer was worn), (3) the evaluation of the costs, benefits, and health care resources used. To this end, we had the collaboration of researchers from the Faculty of Medicine of the University of Porto (1), the School of Education of the Polytechnic Institute of Porto and the Faculty of Sports of the University of Porto (2) and the Swedish Uppsala University (3).
7) Delivery of the GLTP program with 9 groups of parents: 2 face-to-face groups, 1 online pilot group, and 6 online groups (3 groups include parents from the control groups). The online delivery is carried out with the support of the Colibri-Zoom platform and was initially validated through the implementation of a pilot study, which concluded that the digital delivery of the intervention provided results similar to those reported by prior research on the effects of GLTP delivered in person.
8) Participant evaluation took place as planned, before the intervention, after the intervention, and 6 months after the end of the intervention.
9) Data entry was performed as data were collected.
10) data analysis is ongoing.
In addition, the following activities were performed:
1) Project Registration at the Open Science Framework platform (https://osf.io/kvd7n/?view_only=455c4032d61b49dd9eb269bc900bb571), at the ISRCTN platform of BMC Springer Nature (ISRCTN44687723, available at https://doi.org/10.1186/ISRCTN44687723), on the EUROQOL platform for the use of the EQ-5D-Y (number 27404).
2) The psychometric study of the Portuguese version of 3 instruments was carried out: Lifestyle Behavior Checklist, Comprehensive Feeding Practices Questionnaire and Physical Activity Parenting Practices.
3) Dissemination of the project through social networks |
