Weight outcomes of NU-HOME: a randomized controlled trial to prevent obesity among rural children

Jayne A. Fulkerson, Melissa Horning, Daheia J. Barr-Anderson, Abbey Sidebottom, Jennifer A. Linde, Rebecca Lindberg, Sarah Friend, Jennifer Beaudette, Colleen Flattum, Rebecca L. Freese

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Rural children are at greater obesity risk than their urban peers. The NU-HOME study is an innovative collaborative effort to prevent childhood obesity in rural communities. Weight outcomes of the NU-HOME study, a family-meal focused randomized controlled trial (RCT) are described. We hypothesized that compared to control group children, intervention group children would have significantly lower weight-related post-intervention (PI) outcomes. Methods: Participants were 114 dyads (7–10 year-old rural children and a parent). In 2017–2018 and 2018–2019, research staff measured height, weight and body fat at baseline (BL) and PI. Families were randomized to intervention (n = 58) or control (n = 56) groups without blinding. Designed with Social Cognitive Theory and community engagement, the NU-HOME program included seven monthly sessions delivered in community settings and four goal-setting calls. The program engaged entire families to improve healthy eating, physical activity, family meals and the home food environment. Multiple linear and logistic regression models tested PI outcomes of child BMIz-score, percent body fat, percent over 50th percentile BMI, and overweight/obesity status by treatment group, adjusted for BL values and demographics (n = 102). Results: No statistically significant intervention effects were seen for child BMIz or overweight/obesity status. However, a promising reduction in boys’ percent body fat (− 2.1, 95% CI [− 4.84, 0.63]) was associated with the intervention. Conclusions: Although our findings were in the hypothesized direction, making significant impacts on weight-related outcomes remains challenging in community trials. Comprehensive family-focused programming may require intensive multi-pronged interventions to mitigate complex factors associated with excess weight gain. Clinical trial registration: This study is registered with NIH ClinicalTrials.gov: NCT02973815.

Original languageEnglish (US)
Article number29
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
StatePublished - Dec 2022

Bibliographical note

Funding Information:
We want to acknowledge and thank the members of our engaged NU-HOME Action Team. Our deep gratitude goes to the leadership and staff of the New Ulm Public Schools and Sleepy Public Schools and associated partners for recruitment assistance and for allowing us to use their space for the NU-HOME intervention program, the New Ulm and Sleepy Eye Community Education programs for promotion and assistance with scheduling multiple locations for study events, and the New Ulm Medical Center and Sleepy Eye Medical Center staff, partners from the University of Minnesota Extension Service and members of the Brown County Public Health Department for their recruitment assistance and guidance. We are especially grateful for the commitment of our research participants.

Funding Information:
This study was supported by National Institutes of Health (NIH) award 1R01HL123699 (National Heart, Lung, and Blood Institute; NHLBI) as well as award UL1TR002494 (National Center for Advancing Translational Sciences; NCATS) for REDCap software support and statistical services. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHLBI, the NCATS or the NIH.

Publisher Copyright:
© 2022, The Author(s).


  • BMI
  • Body fat
  • Childhood obesity
  • Community
  • Family meals
  • Healthy eating
  • Home food environment
  • Physical activity
  • Prevention
  • Rural
  • Body Mass Index
  • Humans
  • Male
  • Pediatric Obesity/prevention & control
  • Diet, Healthy
  • Exercise
  • Rural Population
  • Meals
  • Child

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article
  • Research Support, N.I.H., Extramural


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