Effect of the Smart Moms intervention on targeted mediators of change in child sugar-sweetened beverage intake

Few parent-targeted interventions have examined the mechanisms of action by which the intervention changes child behavior. The purpose of this study was to test the theoretical and behavioral mediators of the Smart Moms intervention on changes in child sugar-sweetened beverage and juice (SSB/juice) consumption. This is a secondary mediation analysis of data from a 6-month randomized controlled trial (N = 51 mother-child dyads) of a mobile phone–based program to reduce child SSB/juice intake compared with a waitlist control group. Linear mixed models compared changes in intervention targets from baseline to 3 months between treatment groups. Intervention targets that changed significantly between groups were tested in a multiple mediation model to evaluate their significance as mediators of change in child SSB/juice at 6 months. Maternal beverage consumption but no other behavioral or theoretical intervention targets mediated the effect of the intervention on the reduction in child SSB/juice at 6 months. There were few mediators of the intervention on child SSB/juice change. Greater longitudinal research is needed to understand predictors of child dietary changes to inform future intervention efforts. In addition, a greater focus on the measurement of theoretical constructs in family-based child obesity prevention research is needed. •Few parent-targeted interventions examine mechanisms of action on child behavior.•Reductions in maternal beverage intake predict changes in child beverage intake.•Few behavioral intervention targets were changed in this theory-based intervention.•Research should explore predictors of child dietary changes to inform interventions.