Feasibility and preliminary effects of the mindful healthy family project among rural families.

Background/purpose: Rural adults and children are at higher risk for overweight and obesity. However, there are relatively few lifestyle modification programs available for these high-risk families, mainly because of the difficulty in reaching them. This mindfulness-based motivational interviewing (MM-based-MI) pilot aimed to improve parents' healthy eating index (HEI), collective family efficacy, family satisfaction, perceived stress, and depressive symptoms as well as parent-child dyads' eating patterns, physical activity (PA), and body mass index (BMI).

Methods: This randomized controlled trial (RCT) was conducted in the Midwestern US to examine the feasibility (enrollment, attendance, and attrition), acceptability, and preliminary effects of an MM-based-MI intervention that contained nine sessions of health coaching (1-on-1), while the active-control included nine emailed health handouts sent over an 18-week period.

Results: A total of 46 parents (29 intervention, 17 control; M_age= 38.5 years, 85% female) participated. The enrollment rate, intervention attendance rate, and attrition rate were 12.6%, 79.8%, and 23.9% respectively. Although not statistically significant, compared to the control, the MM-based-MI intervention showed positive effects on improving parents' HEI in terms of increasing total HEI score (Cohen's d = 0.43), vegetable intake (d = 0.41), greens/beans (d = 0.59), protein food (d = 0.82), and self-efficacy in exercise (d = 0.21), as well as decreasing total calories (Kcal, d = -0.58), added sugar (d = -0.50), and depressive symptoms (d = -0.42), while controlling for marital status. Controlling for age, sex, and marital status, intervention children had greater improvement in increasing fiber (d = 0.75) and protein (d = 0.72) intake compared to the active-control group. Moreover, parents in both groups reported improvement (small to large effects) in ↑mindful eating, ↑collective family efficacy, ↑family satisfaction, and ↓perceived stress over time.

Conclusions: Despite some limitations (small sample size, virtual at home measurement), our results support the feasibility, acceptability, and preliminary effects of this Mindful Healthy Family program on potentially mitigating some obesogenic behaviors among rural parent-child dyads.

Trial registration: ClinicalTrials.gov identifier: NCT05324969.