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Longitudinal analysis of RCT examines participation influences in low-income caregiver community, highlighting engagement needs.
PurposeRecruitment and retention challenges hinder development of interventions to reduce income-related inequities in childhood obesity and dental caries. We examined whether participation in a digital nutrition and oral health intervention differed by participant and community characteristics.DesignLongitudinal analysis of an ongoing randomized clinical trial (RCT).SettingLow-income communities.Subjects216 caregivers of 2-6-year-old children completed a recruiting program; 154 consented and 79 completed the first component of the RCT.InterventionWe used a digital tailored message program to recruit participants into a RCT, where a virtual, dietitian-facilitated motivational interviewing (MI) session was the first required component for continued participation in the intervention.MeasuresWe assessed demographics and ZIP-code level community characteristics.AnalysisWe used logistic regression models to examine consent for and completion of MI sessions by participant and community characteristics.ResultsCaregivers reporting healthier child diets were more likely to consent to (OR = 1.3, 95% CI = 1.1-1.5 per 20-point on liking-based measure) and complete the MI session (OR = 1.2, 95% CI = 1.0-1.3 per 1-point on frequency-based measure). Those participating in food assistance or educational programs for low-income children (OR = 0.5; 95% CI = 0.2-0.9), and from communities with greater social vulnerability related to housing/transportation (OR = 0.7, 95% CI = 0.5-1.0) were less likely to complete the MI session.ConclusionsApproaches are needed that engage vulnerable families in nutrition and oral health interventions, thereby enhancing efforts to promote health equity.
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Killion et al. (2026) studied this question.
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