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Table 1 Program Content of the ‘Strong Families Trial’ intervention

From: Protocol for a randomised controlled trial of a family strengthening program to prevent unhealthy weight gain among 5 to 11-year-old children from at-risk families: the Strong Families Trial

Type of Session

Session Number

Module Title

Objectives

Key Messages

Activities

Healthy Lifestyle Modules

Module 1

Building Healthy Habits

• Welcome participants, provide an opportunity for introductions and explore participant expectations and motivations for the program.

• To promote a safe and supportive environment with which participants can actively engage.

• To orient participants to the program.

• To define key concepts.

• Introduce the key healthy lifestyle messages.

• To promote healthy drinking habits in children.

• To promote physical activity as a part of a healthy lifestyle.

• To encourage a reduction in sedentary behaviours.

• Promote the importance of sufficient sleep each day for children.

• Strong families can be healthy together by following healthy lifestyle habits every day.

• Choose water as a drink.

• Be active every day for at least 60 mins.

• Decrease screen time to move more and sit less.

• Sleep plays an important role in your child’s health.

1.1 Welcome & introductions

 • Welcome

 • Session overview

 • Activity 1: Getting to know each other

 • Our group rules

1.2 Strong families

 • Program structure

 • Strong, healthy families

 • Healthy lifestyle habits

1.3 Choose water as a drink

 • Drink water instead of soft drink, juice or cordial

 • Activity 2: How much sugar

 • Tips for kids to drink more water

1.4 Getting active each day

 • Activity 3: Shake it out

 • Getting active every day

 • Active families

1.5 Switch off screens

 • Healthy screen use

 • Managing screen time

1.6 Sleep

 • Get enough sleep

 • Healthy sleep habits

1.7 Wrap-up

 • Key messages

 • Take-home activities

 • Questions

 • Feedback

Module 2

Healthy Eating Every Day

• Provide an overview of the session and recap key messages from previous session.

• Introduce participants to concept of ‘everyday’ foods and ‘sometimes’ foods using the Australian Guide to Healthy Eating (AGHE) and the five food groups.

• Highlight the main nutrients & portion sizes for each of the five ‘everyday’ food groups and promote the benefits of healthy eating.

• Increase participants understanding that ‘sometimes’ foods should be limited as they are high in fat, salt & sugar.

• Introduce positive parenting feeding practices to promote development of healthy eating habits.

• Encourage participants to enjoy breakfast each day.

• Promote the importance of a healthy lunch box and snack choices and encourage increased intake of fruit & vegetables through these choices.

• Eat ‘everyday’ foods from the five food groups.

• Increase ‘everyday’ foods and limit intake of ‘sometimes’ foods.

• Children need a balance of foods and drinks for optimal growth and development.

• Strong, healthy families enjoy eating together.

• Breakfast is a great way to start the day.

• Healthy lunchboxes and snacks contain ‘everyday foods’.

2.1 Introduction

 • Welcome

 • Module 2 overview

 • Recap - Module 1

2.2 Understanding healthy eating

 • ‘Everyday’ & ‘sometimes’ foods

 • Healthy fats

 • ‘Sometimes’ foods

2.3 Healthy eating habits

 • Building healthy eating habits

2.4 Good start to the day

 • Why is breakfast important?

 • What is in a healthy breakfast?

 • Breakfast helpers

2.5 Healthy lunch & snack habits

 • Healthy lunch & snack habits

 • Lunchbox & snack helpers

 • Activity 1: ‘Everyday’ lunches & snacks

2.6 Wrap-up

 • Key messages

 • Take-home activities

 • Questions

 • Feedback

Module 3

Making Healthy Choices

• Allow participants to reflect on prior learning and to provide an overview of the module

• To encourage limited intake of takeaway foods with high sugar, salt and fat through healthier food choices.

• For parents to develop skills to enable them to modify recipes into healthier options.

• For parents to be able to confidently read food labels & nutrition symbols to inform healthy choices.

• To highlight that pre-planning can help make healthy food purchases and that healthy eating need not be expensive

• Simple swaps make favourite meals healthier

• Understanding food labels can help you make healthy food choices at the supermarket.

• Healthy food choices can be easy, convenient and affordable.

3.1 Introduction

 • Welcome

 • Module 3 overview

 • Recap - Module 2

3.2 Smart food swaps

 • Smart swaps for cooking

 • Healthier cooking methods

 • Healthy choices away from home

 • Activity 1: Recipe makeovers

3.3 Understanding food labels

 • How to read a food label

 • Nutrition information

 • Ingredients

 • Front of pack labelling

 • Activity 2: Food detectives

3.4 Smart supermarket choices

 • Isn’t healthy eating more expensive?

 • Healthy shopping habits

 • Supermarket savvy

 • Combating pester power

3.5 Wrap-up

 • Key messages

 • Take-home activities

 • Questions

 • Feedback

Parenting Modules

Module 4

Building Strong Families

• Provide an overview of the module and highlight the importance of family functioning on a family’s health

• Explore participant’s expectations and experiences of becoming parents

• Introduce the essential components of a strong family

• Develop an understanding of the sequence of physical, emotional, social and cognitive changes that occur in children

• Our expectations and experiences of becoming a parent have been shaped by many things including our upbringing, values, family and cultural influences.

• During childhood your child develops physically, emotionally, socially and cognitively. The relationship with their family plays an important role in supporting this development.

• Children need strong families in order to thrive.

• A strong family has emotional and physical security, lots of warmth, care and positive attention, firm, fair rules and boundaries, good communication and connections to others outside of the family.

4.1 Introduction

 • Welcome participants

 • Introduction to Module 4

4.2 Becoming a parent

 • Thoughts about becoming a parent

4.3 Essential components of a strong family

 • Strong Families

 • Activity 1: Bullseye

4.4 Understanding childhood development

 • Child developmental milestones

4.5 Wrap-up

 • Key messages

 • Take-home activities

 • Questions

 • Feedback

Module 5

Praise, Rewards, Rules & Consequences

• Highlight the role of positive attention, praise and rewards in promoting good behaviour

• Promote the importance of limit setting as a means to guide children’s behaviour

• Develop an understanding of how to use consequences as a strategy to manage their children’s behaviour effectively.

• Family rules help create structure and can help guide children to understand what behaviours are okay and not okay.

• The way that you respond to your child’s behaviour directly influences whether they are more or less likely to engage in the behaviour again.

• Physical punishment (e.g. smacking) is not an effective way to help children to follow rules.

5.1 Introduction

 • Welcome

 • Introduction to Module 5

5.2 Promoting positive behaviour

 • The importance of praise

 • Tips for using praise

 • Rewards

5.3 Setting family rules

 • Family rules – what are they and why are they important?

 • Developing family rules

 • Following the rules: what to expect

5.4 Responding to children’s behaviour

 • Smacking- It is never okay

 • Using consequences effectively

 • Activity 1: How would I respond?

5.5 Wrap-up

 • Key messages

 • Take-home activities

 • Questions

 • Feedback

Module 6

Improving Communication & Managing Emotions

• Explore challenges in communication and provide parents with tools for more effective communication.

• Gain an understanding of how to support children to identify and manage their emotions effectively.

• Equip parents with strategies to manage stress, highlighting the importance of self-care and support networks.

• Explain the importance of chores.

• The way that we communicate with others has a significant impact on the quality of our relationship and on the outcomes of our interaction.

• Emotions such as joy, sadness, fear, anger and disgust can occur daily. It is important to find healthy ways to express our emotions.

• Stress is a normal part of life and is experienced by everyone from time to time. However, when stress is frequent or severe, it can impact on your quality of life and therefore it needs to be effectively managed.

• Self-care can enhance your health and wellbeing and is vital in helping you care for others.

• Assigning chores to family members can help reduce stress, while supporting children to develop essential life skills.

6.1 Introduction

 • Welcome

 • Introduction to Module 6

6.2 Improving family communication

 • Activity 1: Follow the instructions

 • Communication skills for your family

 • Teaching children how to communicate

6.3 Understanding emotions

 • The importance of understanding emotions

 • Activity 2: Identify the emotion

 • Helping children to deal with big emotions

6.4 Reducing stress

 • The basics of stress

6.5 Sharing the load

 • Chores for children

6.6 Wrap-up

 • Program recap

 • Activity 3: Creating a maintenance plan

 • Wrapping up and Next Steps

 • Feedback

Booster Sessions

Booster Session A

Healthy Lifestyles

• Welcome participants and introduce them to the first booster session.

• Revise and assess participants understanding of the key messages of the healthy lifestyle modules.

• Review implementation of Strong Families maintenance plan.

• Ensure that participants have a thorough understanding of all key messages by addressing any questions and areas of concern.

• It is important to maintain the progress you have made in the Strong Families program to ensure that your family stays strong and healthy.

A.1 Introduction

 • Welcome

 • Introduction to Booster A

A.2 Review of Healthy Lifestyle modules

 •Review of key messages

A.3 Positive changes & ongoing challenges

 •Reflecting on learning

A.4 Troubleshooting & wrap up

 •Troubleshooting

 •Feedback

 •Wrap up

Booster Session B

Parenting

• Welcome participants and introduce them to the second booster session.

• Revise and assess participants understanding of the key messages of the parenting modules.

• Review implementation of Strong Families maintenance plan.

• Ensure that participants have a thorough understanding of all key messages by addressing any questions and areas of concern.

• It is important to maintain the progress you have made in the Strong Families program to ensure that your family stays strong and healthy.

B.1 Introduction

 •Welcome

 •Introduction to Booster B

B.2 Review of Parenting modules

 •Review of key messages

B.3 Positive changes & ongoing challenges

 •Reflecting on learning

B.4 Troubleshooting & wrap up

 •Troubleshooting

 •Feedback

 •Wrap up