A three-year multifaceted intervention to prevent obesity in children of Mexican-heritage

Banafsheh Sadeghi, Lucia L Kaiser, Meagan M Hanbury, Iraklis Erik Tseregounis, Ulfat Shaikh, Rosa Gomez-Camacho, Rex C Y Cheung, Alberto L Aguilera, Linda Whent, Adela de la Torre, Banafsheh Sadeghi, Lucia L Kaiser, Meagan M Hanbury, Iraklis Erik Tseregounis, Ulfat Shaikh, Rosa Gomez-Camacho, Rex C Y Cheung, Alberto L Aguilera, Linda Whent, Adela de la Torre

Abstract

Background: Obesity and overweight have increased dramatically in the United States over the last decades. The complexity of interrelated causal factors that result in obesity needs to be addressed within the cultural dynamic of sub-populations. In this study, we sought to estimate the effects of a multifaceted, community-based intervention on body mass index (BMI) among Mexican-heritage children.

Methods: Niños Sanos, Familia Sana (Healthy Children, Healthy Family) was a quasi-experimental intervention study designed to reduce the rate of BMI growth among Mexican-heritage children in California's Central Valley. Two rural communities were matched based on demographic and environmental characteristics and were assigned as the intervention or comparison community. The three-year intervention included parent workshops on nutrition and physical activity; school-based nutrition lessons and enhanced physical education program for children; and a monthly voucher for fruits and vegetables. Eligible children were between 3 and 8 years old at baseline. Intent-to-treat analyses were estimated using linear mixed-effect models with random intercepts. We ran a series of models for each gender where predictors were fixed except interactions between age groups and obesity status at baseline with intervention to determine the magnitude of impact on BMI.

Results: At baseline, mean (SD) BMI z-score (zBMI) was 0.97 (0.98) in the intervention group (n = 387) and 0.98 (1.02) in the comparison group (n = 313) (NS). The intervention was significantly associated with log-transformed BMI (β = 0.04 (0.02), P = 0.03) and zBMI (β = 0.25 (0.12), P = 0.04) among boys and log-transformed BMI among obese girls (β = - 0.04 (0.02), P = 0.04). The intervention was significantly and inversely associated with BMI in obese boys and girls across all age groups and normal weight boys in the oldest group (over 6 years) relative to their counterparts in the comparison community.

Conclusions: A community-based, multifaceted intervention was effective at slowing the rate of BMI growth among Mexican-heritage children. Our findings suggest that practitioners should consider strategies that address gender disparities and work with a variety of stakeholders to target childhood obesity.

Trial registration: clinicaltrials.gov Identifier: NCT01900613 . Registered 16th July 2013.

Keywords: Childhood obesity; Mexican-origin communities; Multifaceted; Rural area communities; community-based intervention.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the University of California (UC), Davis Institutional Review Board. Legal guardians of eligible children provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Consort Flow Diagram
Fig. 2
Fig. 2
NSFS BMI Trajectoriesa by Baseline Weight Status, by Gender

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