Abstract
OBJECTIVE: This study explores the impact of iAmHealthy, a rurally focused pediatric obesity intervention, on mental health outcomes and examines how baseline mental health affects body mass index (BMI) outcomes for child-parent dyads in rural communities. METHOD: Eighteen schools were randomly assigned to iAmHealthy or the Newsletter Control group. iAmHealthy consists of health coaching and group sessions via televideo. Child and parent height and weight, child depression, child quality of life, and parent distress were assessed at baseline, posttreatment (8 months), and follow-up (20 months) from October 2017 to December 2021. Multilevel modeling assessed treatment effects on mental health and baseline mental health on change in BMI outcomes. RESULTS: In total, 148 dyads were randomized to iAmHealthy (n = 64) or control (n = 84). Dyads broadly reported minimal parent distress, child depressive symptoms, and high child quality of life. While there was no treatment group by time interactions, the iAmHealthy group had significant decreases in child depression at posttreatment and follow-up and significant decreases in parent distress at follow-up. Control participants had no significant changes in child depression, quality of life, or parent distress at any time point. Significant interactions between treatment group and baseline mental health predicted child body mass index z score/parent BMI change. CONCLUSIONS: Parents experiencing baseline distress particularly benefited from the support of iAmHealthy, but unsustained effects at follow-up suggest that long-term support may be beneficial to these families. Future studies examining populations with heightened mental health challenges may provide deeper insights into how pediatric obesity interventions affect mental well-being within families from rural communities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).