ANDALE Pittsburgh: results of a promotora-led, home-based intervention to promote a healthy weight in Latino preschool children

Abstract

BackgroundLatino preschool children have higher rates of obesity than preschool children from other racial/ethnic groups; however, few effective, culturally appropriate interventions exist targeting this group. The purpose of this study was to test the feasibility of a 10-week, promotora-mediated, home-based intervention to promote a healthy weight in Latino preschool children.MethodsTrained promotoras (community health workers) delivered 10, 90-min weekly interactive and tailored sessions to Latino families living in Allegheny County. Participants were recruited through promotoras’ own social networks and community gatherings, flyers, and word of mouth. Primary outcome measures included child body mass index (BMI) z-score and percentile. Secondary outcome measures included child objectively measured physical activity and dietary intake, and the home social and physical environment (e.g., parent health behaviors, parent self-efficacy, parental support, physical activity equipment in the home). The final analysis sample included 49 of 51 participants who completed both baseline and follow-up assessments.ResultsParticipants included mothers (33.5 ± 6.1 years old) and their preschool-aged children who were primarily 1st generation immigrants from Mexico (65%). The primary analyses of BMI percentile and z-score showed no change post-intervention. However, there was a significant decrease in child BMI percentile for overweight and obese children from baseline to follow-up (p < .05). We also saw significant pre/post increases in child daily fruit and vegetable intake, and parent moderate-to-vigorous physical activity, fruit and vegetable servings per day, and self-efficacy; and significant decreases in child saturated fat and added-sugar intake, and child and parent screen time (p’s < .05).ConclusionsDespite the short duration of the intervention and follow-up, this pilot study showed promising effects of a promotora-mediated intervention to promote a healthy weight in Latino preschool children.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5266-3) contains supplementary material, which is available to authorized users.

Feasibility and acceptability of a home‐based intervention to promote nurturing interactions and healthy behaviours in early childhood: The Amagugu Asakhula pilot study

“…These mostly U.S. interventions have shown some effect on behaviours but no effect on weight-related outcomes (Showell et al, 2013), including in older children (Bleich et al, 2018). Culturally appropriate home-based obesity prevention interventions targeting preschool children that have been implemented by community-based workers have shown promising findings with regard to feasibility and changes in obesity-related behaviours (Haines et al, 2013;Sosa, Parra-Medina, He, Trummer, & Yin, 2016; Taverno Ross, Barone Gibbs, Documet, & Pate, 2018;Yun et al, 2015), with some significant improvements in weight-related outcomes in overweight and obese children (Taverno Ross et al, 2018).…”

Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries

“…Recruitment by disadvantaged socioeconomic groups were based on ethnicity [ 32 – 35 , 40 – 43 ] and age [ 32 – 35 , 42 ]. The ethnic minority groups in question were Hispanics [ 40 , 41 , 43 ], Koreans [ 40 ], Native Americans [ 42 ] and African Americans [ 32 – 35 ]. McLeish and Redshaw used HIV diagnosis rather than ethnicity as a basis for recruitment, but the large majority of their participants were immigrant women with a Sub-Saharan African background [ 44 ].…”

“…Another study also relied on referrals to the intervention program, but did not specify who were responsible for those referrals [ 39 ]. Taverno Ross et al [ 41 ] reported using promotoras who recruited participants in the study from their own social networks. This was done during community gatherings, through flyers and word of mouth.…”

“…The most frequent topic for the studies with a single focus was breastfeeding, where initiation rates, duration and exclusivity were evaluated quantitatively, [ 33 , 36 , 46 , 49 , 50 ] along with qualitative evaluations of experiences of receiving breastfeeding support programs [ 47 – 49 ]. Child nutrition and overweight prevention was the focus in three of the studies, with changes in BMI [ 41 , 43 ], physical activity [ 41 ] and micronutrient intake [ 50 ] being reported. Two studies reported on how quantified measures of parent-child interaction and attitudes changed during interventions [ 32 , 42 ].…”

“…An alternative to this approach, described by Ingram [ 49 ] and Graffy et al [ 46 ], was to only plan one prenatal home visit and subsequently arrange more visits if the supported parents expressed a need for it, otherwise relying on phone-based support. A common frequency for home visits was consistent weekly face-to-face contact [ 32 – 35 , 41 , 48 ], though some studies focusing on perinatal health used weekly visits during pregnancy with lower frequency postnatally [ 39 , 42 ]. Biweekly [ 37 , 40 , 45 ] and monthly visits [ 36 , 43 , 50 ] were used by three interventions.…”