Central American Parents’ Preferences for Content and Modality for a Family-Centered Intervention to Promote Healthful Energy Balance-Related Behaviors of Their Preschool-Age Children

Abstract

This formative research used a cross-sectional survey to assess interest in informational content and intervention modalities for the design of an early childhood obesity prevention intervention for Central American families from the Northern Triangle countries (El Salvador, Guatemala, and Honduras) living in the United States. A total of 74 parents (36 mothers, 38 fathers) with a mean age of 31.6 years (SD = 5.6) completed the survey; 59.5% of whom were born outside of the United States. Although most parents reported being very interested in receiving information related to the seven assessed energy balance-related behaviors, there were significant differences by parents’ gender and nativity. Most parents endorsed remote modalities for content delivery via text/SMS, WhatsApp, and e-mail. However, respondents were also receptive to in-person delivery provided by community health workers. There were also significant differences in parents’ preferences for intervention modalities by parents’ gender and nativity. Future steps should include investigating different intervention modalities and their integration into a linguistic and culturally sensitive family-based intervention to promote healthful energy balance-related behaviors of preschool-age children in Central American families originating from the Northern Triangle countries.

Brazilian Immigrant Parents’ Preferences for Content and Intervention Modalities for the Design of a Family-Based Intervention to Promote Their Preschool-Age Children’s Healthful Energy Balance-Related Behaviors

“…The core survey included 44 items divided into three sections [ 22 , 31 , 40 ]. The original survey instrument developed in English was translated (Spanish and Portuguese) and pilot-tested for use with Hispanics [ 50 , 51 ] and Brazilians [ 31 ]. The first section had six items assessing parents’ perception of the importance of EBRBs for their preschool-aged children framed in terms of current public health recommendations (3 on healthy eating behaviors [promoting consumption of five or more fruits and vegetables per day, reducing consumption of unhealthy/junk foods, and reducing consumption of SSB, and 3 items on healthy 24 h movement behaviors [promoting at least 90 min of daily PA, limiting screen time to less than two h/day, and promoting 10 h sleep/night]) [ 31 , 50 , 51 ].…”

“…The second section included items assessing sources used by parents to obtain information to support EBRBs of their preschool-aged children (12 items). The third section included 26 items assessing parents’ preferences for a family-based intervention to promote healthful EBRBs, including content (7 items), delivery channels (11 items), access and use of communication technology (7 items), and language preference (1 item) [ 31 , 50 , 51 ].…”

“…Additionally, the survey included a section with two items assessing parents’ self-identified weight and their perceptions of their preschool-age child’s weight status (underweight, normal weight, overweight, obese), a section on sociodemographic characteristics (age, marital status, country of birth, years of residency in the U.S., primary language spoken, educational attainment, and annual household income) used in several of our previous studies with Brazilian immigrants in the U.S. [ 31 , 46 , 47 , 48 , 49 , 50 , 51 ], access and type of health insurance, and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) [ 31 , 46 , 47 , 48 , 49 , 50 , 51 ]. Finally, the survey included the Short Acculturation Scale for Hispanics (SASH), a 12-item scale assessing participants’ acculturation level [ 52 ] that was used in our previous studies with Brazilian parents [ 31 , 46 , 47 , 48 , 49 ].…”

“…), (4) drink more water, (5) be more physically active, (6) reduce the use of electronics (e.g., television, iPad, iPhone, computer, video game, etc.) or have less screen-time, (7) have adequate sleep every night (i.e., >10 h/night)” (5-point Likert scale: 1 = not interested to 5 = very interested) [ 31 , 50 , 51 ].…”

“…Preference for delivery channels or intervention modalities (11 items) was measured by the following questions: “If you were to enroll in a health promotion program for parents of preschool-age children, what would be your preference to receive such information?” (5-point Likert scale: 1 = completely disagree—5 = completely agree): (1) email, (2) text or SMS, (3) WhatsApp, (4) social media (e.g., Facebook, Instagram, Pinterest, etc. ), (5) English language website, (6) Portuguese language website, (7) telephone calls by trained community health workers (CHWs), (8) individual sessions delivered by trained CHWs, (9) short duration courses offered by trained CHWs, (10) short-duration courses offered by trained parents like me or peer parents, and 11) printed materials [ 31 , 50 , 51 ]. Access and use of technology (7 items) was measured by the following questions: “Do you have a computer at home?” (yes, no); “Do you have access to Internet at home?” (yes, no); “How often do you check your email?” (daily, more than once a week, less than once a week, once or less a month); “Do you have a mobile telephone where you can receive SMS/Text?” (yes, no); “Do you use WhatsApp?” (yes, no); “Do you use social media (e.g., Facebook, Instagram, Pinterest)” (yes, no); “How often do you check messages on your WhatsApp, SMS/text, or social media?” (daily, more than once a week, less than once a week, once or less a month) [ 31 , 50 , 51 ].…”