The NU-HOME RCT Home Food Environment, Family Meal Frequency, Meal Quality and Children's Dietary Intake and Physical Activity Outcomes.

INTRODUCTION: The assessment of secondary outcomes in childhood obesity RCTs is important to understand programmatic impacts and precursors to weight-related changes. STUDY DESIGN: RCT. Baseline and post-intervention (9 months, 86% retention) data were collected (2017-2019) and analyzed (2022) for 114 7-10-year-old participants in the New Ulm at HOME (NU-HOME) study, which aimed to prevent obesity in rural children. The NU-HOME intervention engaged whole families in 7 monthly in-person, interactive sessions promoting healthful home food environments (i.e., frequent family meals, home availability of fruits and vegetables, high quality of foods served at meals), children's dietary intake (i.e., diet quality via HEI and FV and low SSB intake), and children's physical activity (PA; i.e., MVPA and reduced screen time). MAIN OUTCOME MEASURES: Family home food environment; child dietary intake and PA outcomes. RESULTS: Compared to families in the wait-list control group, families in the intervention group showed significantly greater improvement in the availability of vegetables in the home (p<.05) and the quality of foods and beverages served at the evening meal (p<.05). Although not statistically significant (p=0.07), children in the intervention group demonstrated a 1/3 cup increase in fruit consumption compared to children in the control group, a clinically meaningful outcome. No significant treatment group differences were seen for family meal frequency, home availability of fruit, intake of vegetables, SSB intake, or minutes of moderate-to-vigorous PA and screen time. CONCLUSIONS: Our findings of significant beneficial changes in the home availability of vegetables and the quality of food and beverages served at meals demonstrate the positive, albeit limited, impact of the NU-HOME program on the home food environment for rural children.