An eHealth Intervention, Called Healthy Online Parental Education (HOPE), Improves Vegetable Intake and Active Play Among Toddlers From Low-Income Families in West Texas

OBJECTIVES: The objective of this study was to evaluate a parent-focused eHealth intervention aimed at improving fruit and vegetable intake and active play among toddlers in West Texas. METHODS: A randomized controlled trial was conducted among 73 parents with toddlers between August and December 2021. Intervention group participants (n = 37) completed weekly videos and biweekly online cooking activities through the Healthy Online Parental Education (HOPE) website for a total of 8 weeks. The HOPE intervention curriculum was informed by the Social Cognitive Theory. Control group participants (n = 36) received printed materials about dietary recommendations for children. The primary outcomes were fruit and vegetable intake and physical activity among children. Secondarily, parents completed an assessment in nutritional knowledge, self-efficacy, and feeding practices. There were two data collection points at baseline and post-intervention. A linear mixed model was performed to compare intervention with control group effects over time on study outcomes. RESULTS: More than half of the children were male (56%) with a mean age of 27 months. Children in the intervention group showed a small but significant increase in vegetable intake by 0.75 servings (P < 0.05) than in the control group. There was a significant increase in active playtime by 19.88 minutes in the intervention group (P < 0.05). Parents in the intervention group significantly increased their scores in nutritional knowledge (p = 0.01), self-efficacy around feeding (p = 0.02), and healthy modeling practices (P < 0.05) at post-intervention. There was no significant difference in child fruit intake between the intervention and control group at post-intervention. CONCLUSIONS: The HOPE program was successful in improving vegetable intake and active playtime among toddlers, but not fruit intake at post-intervention. Parent-focused eHealth interventions may have the potential to address child health disparities in areas where the communities are underserved. The HOPE trial was registered at clinicaltrials.gov as NCT05085041. FUNDING SOURCES: This study was partially funded by the Graduate School at Texas Tech University.