Background Due to multiple and interacting factors, Latino children are disproportionately at risk for overweight and obesity in the United States. Childhood obesity increases the risk for adverse physical and psychosocial outcomes throughout the lifespan. Intensive behavioral interventions recommended in primary care settings may not conform to current practices, and the most vulnerable populations are often unable to access these services. Community Health Workers (CHWs) off e r a promising approach to bridging the gap between vulnerable communities and culturally competent services. La Vida Buena (The Good Life) is an 8-week family-focused intervention for Latino children 5–8 years old and their parents or caregivers who are patients at a Federally-Qualified Community Health Center (FQHC). It is a culturally and linguistically appropriate curriculum, facilitated by CHWs, that targets family behaviors to foster a healthy lifestyle in order to prevent and mitigate childhood overweight and obesity. Methods The primary objective is to test the effectiveness of the La Vida Buena (LVB) childhood obesity program among Latino children 5–8 years old and their families as compared with a single educational session. This study uses a parallel two-arm quasi-experimental design. The intervention group receives the 8-week La Vida Buena intervention and the comparison group receives a single educational session. The primary outcome is the change in the child’s BMI z-score from baseline to 6 months. Discussion The implementation and evaluation of La Vida Buena may inform research and practice for linking Latino patients in FQHCs to culturally responsive community-based childhood obesity interventions. It will also contribute to the literature about CHWs as facilitators of behavior change for families underserved by health services and preventive programs. La Vida Buena can serve as a culturally and linguistically appropriate early intervention curriculum that will foster a healthy home environment for childhood obesity mitigation and prevention. Trial registration The trial was retrospectively registered on December 18, 2018. The ClinicalTrials.gov Identifier is NCT03781856.
Objective To evaluate the effectiveness of the 8-week, community health worker (CHW)–led La Vida Buena childhood obesity program among Latino children 5 to 8 years old in a rural county along the U.S.-Mexico border. Methods This quasi-experimental study used a community-based participatory research approach to compare the effectiveness of the La Vida Buena (The Good Life) curriculum as compared with a single educational session. We took anthropomorphic measures and administered parent-reported nutrition and physical activity surveys at baseline, 3 months, and 6 months. The study took place between 2017 and 2020 in Santa Cruz County, Arizona. Results Change in body mass index (BMI) z-score was negligible for both groups. The parent-reported behavior indicated a shift toward healthier family behaviors and environment in the intervention group. Implications for Practice This study adds to the growing literature of CHW-led childhood obesity interventions. The engagement of the CHWs in all aspects of the intervention helped to facilitate important behavior changes. Future interventions should emphasize health and wellness rather than BMI z-score and include community, socioeconomic, and systems-level interventions to promote healthy environments.
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Objective: In this paper, we describe an approach to engage young children in evaluating the impact of La Vida Buena, a community health worker–led childhood obesity intervention for Latino children aged 5–8 years. Design: This paper describes the collaborative process used to pilot, refine, implement and evaluate evaluation activities, including a drawing and sorting activity, with child participants. Setting: La Vida Buena was implemented with Latino children aged 5–8 years and their parents or caregivers. The children were patients at a Federally Qualified Community Health Centre in a rural town on the US–Mexico Border. The intervention was implemented in a community setting. Methods: Participants were invited to participate in Guided Evaluation Activities during the 3-month and 6-month data collection points. Children participated in a drawing and sorting activity and discussion facilitated by teenage health facilitators or a community health worker. An observer took notes during the activities, and results were analysed by a university evaluator and La Vida Buena staff. Results: Findings demonstrated that the children understood some key messages of the class and identified important areas for improvement in the curriculum content and delivery. Conclusion: By designing evaluation methods that take the unique needs and perspectives of children into account, health promotion programmes can move beyond relying on parent-centric evaluation approaches and gain a deeper understanding of how children experience health intervention programmes.
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