Prevention Science

, Volume 16, Issue 3, pp 408–419 | Cite as

Preventing Weight Gain and Obesity: Indirect Effects of the Family Check-Up in Early Childhood

  • Justin D. Smith
  • Zorash Montaño
  • Thomas J. Dishion
  • Daniel S. Shaw
  • Melvin N. Wilson


The early signs of obesity are observable in early childhood. Although the most promising prevention approaches are family-centered, few relevant early prevention programs exist. This study evaluated the effects of an evidence-based, home-visiting intervention, the Family Check-Up (FCU), on the trajectory of children’s weight gain. The FCU was designed to prevent the development of behavior problems by improving family management practices; children’s weight has not been an explicit target. On the basis of previous research and conceptual models, we hypothesized that intervention effects on parenting practices, specifically caregivers’ use of positive behavior support (PBS) strategies in toddlerhood, would mediate improvements in children’s weight trajectories. A total of 731 indigent caregiver–child dyads from a multisite randomized intervention trial were examined. Observational assessment of parenting and mealtime behaviors occurred from age 2–5 years. The child’s body mass index (BMI) was assessed yearly from age 5–9.5 years. Path analysis with a latent growth model revealed a significant indirect effect of the FCU on the trajectory of BMI in later childhood. Improvements in caregivers’ PBS in toddlerhood, which was related to the nutritional quality of the meals caregivers served to the child during the mealtime task, served as the intervening process. Furthermore, findings indicate that the FCU prevents progression to overweight and obese status amongst at-risk children. These study results add to existing evidence that has demonstrated that family-based interventions aimed at improving general family management skills are effective at preventing weight gain. Future directions are discussed.


BMI Family intervention Latent growth model Pediatric obesity Translational research 



This research was supported by National Institute on Drug Abuse grant DA016110 to the third, fourth, and fifth authors. The second author was supported by minority fellowship SM60563-40 from the Department of Health and Human Services. Seed funding from the College of Liberal Arts and Sciences at Arizona State University awarded to Thomas Dishion supported the first and second authors. The authors also gratefully thank Charlotte Winter and Shannon McGill for assistance with the data management, Cheryl Mikkola for editorial support, the observational coding team at the Child and Family Center, the rest of the Early Steps team in Eugene, Pittsburgh, and Charlottesville, and the families who have participated in the study.

Conflict of Interest

Justin D. Smith, Zorash Montaño, Thomas J. Dishion, Daniel S. Shaw, and Melvin N. Wilson have no conflicts of interest or financial relationships relevant to this article to disclose.


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Copyright information

© Society for Prevention Research 2014

Authors and Affiliations

  • Justin D. Smith
    • 1
    • 5
  • Zorash Montaño
    • 1
  • Thomas J. Dishion
    • 1
    • 2
  • Daniel S. Shaw
    • 3
  • Melvin N. Wilson
    • 4
  1. 1.REACH InstituteArizona State UniversityPhoenixUSA
  2. 2.Child and Family CenterUniversity of OregonEugeneUSA
  3. 3.University of PittsburghPittsburghUSA
  4. 4.University of VirginiaCharlottesvilleUSA
  5. 5.Department of Psychology and NeuroscienceBaylor UniversityWacoUSA

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