Background

The relative reinforcing value (RRV) of food, or how rewarding one finds eating compared to alternative activities, predicts obesity in children and adults. The promotion of alternative reinforcers, or rewarding activities that could take the place of eating, could help to promote healthy weight outcomes. The overall objective of this pilot study was to promote positive parent-child interactions in the context of interactive reading, hypothesizing that these could function as a novel alternative reinforcer, decreasing the RRV of food.

Methods

Twelve 4-to-5-year-old children (M=4.75+0.53 years; 66.7% female) with at least one overweight parent participated, completing a 7-day home-based intervention promoting positive parenting during reading and baseline and follow-up RRV assessments in the laboratory. RRV of food was calculated as the maximum schedule reached when working for access to food divided by the maximum schedule for food plus the maximum schedule for reading with a parent. Intervention compliance was assessed via daily photographs of parent/child reading. Intervention acceptability was parent reported.

Results

Children’s RRV of food decreased from baseline (Mdn=0.83) to follow-up (Mdn=0.50). This change corresponds to a medium-to-large effect (d=0.64). Changes in maximum schedules reached for food and reading were not significant, but magnitudes were consistent with both a decrease in food reinforcement (from Mdn=96.0 to 48.0) and an increase in reinforcement of reading with a parent (from Mdn=4.0 to 32.0). Eleven families (92%) submitted 7 photographs of parent/child reading. Parent perspectives supported intervention feasibility.

Conclusions

Findings provide initial support for this intervention and highlight areas for further investigation.