Niños Sanos, Familia Sana: Mexican immigrant study protocol for a multifaceted CBPR intervention to combat childhood obesity in two rural California towns

Adela de la Torre, Banafsheh Sadeghi, Richard D Green, Lucia L Kaiser, Yvette G Flores, Carlos F Jackson, Ulfat Shaikh, Linda Whent, Sara E Schaefer, Adela de la Torre, Banafsheh Sadeghi, Richard D Green, Lucia L Kaiser, Yvette G Flores, Carlos F Jackson, Ulfat Shaikh, Linda Whent, Sara E Schaefer

Abstract

Background: Overweight and obese children are likely to develop serious health problems. Among children in the U.S., Latino children are affected disproportionally by the obesity epidemic. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a five-year, multi-faceted intervention study to decrease the rate of BMI growth in Mexican origin children in California's Central Valley. This paper describes the methodology applied to develop and launch the study.

Methods/design: Investigators use a community-based participatory research approach to develop a quasi-experimental intervention consisting of four main components including nutrition, physical activity, economic and art-community engagement. Each component's definition, method of delivery, data collection and evaluation are described. Strategies to maintain engagement of the comparison community are reported as well.

Discussion: We present a study methodology for an obesity prevention intervention in communities with unique environmental conditions due to rural and isolated location, limited infrastructure capacity and limited resources. This combined with numerous cultural considerations and an unstable population with limited exposure to researcher expectations necessitates reassessment and adaptation of recruitment strategies, intervention delivery and data collection methods. Trial registration # NCT01900613.

Trial registration: NCT01900613.

Figures

Figure 1
Figure 1
Map of California highlighting Fresno county.
Figure 2
Figure 2
Polar™ Active accelerometer.

References

    1. Pan L, Blanck HM, Sherry B, Dalenius K, Grummer-Strawn LM. Trends in the prevalence of extreme obesity among US preschool-aged children living in low-income families, 1998–2010. JAMA. 2012;308:2563–2565. doi: 10.1001/jama.2012.108099.
    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–490. doi: 10.1001/jama.2012.40.
    1. Branscum P, Sharma M. A systematic analysis of childhood obesity prevention interventions targeting Hispanic children: lessons learned from the previous decade. Obesity Rev. 2011;12:e151–e158. doi: 10.1111/j.1467-789X.2010.00809.x.
    1. Barkin SL, Gesell SB, Po’e EK, Escarfuller J, Tempesti T. Culturally tailored, family-centered, behavioral obesity intervention for Latino-American preschool-aged children. Pediatrics. 2012;130:445–456. doi: 10.1542/peds.2011-3762.
    1. Slusser W, Frankel F, Robison K, Fischer H, Cumberland WG, Neumann C. Pediatric overweight prevention through a parent training program for 2–4 year old Latino children. Child Obesity. 2012;8:52–59.
    1. Crespo NC, Elder JP, Ayala GX, Slymen DJ, Campbell NR, Sallis JF, McKenzie TL, Baquero B, Arredondo EM. Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the Aventuras Para Niños study. Ann Behav Med. 2012;43:84–100. doi: 10.1007/s12160-011-9332-7.
    1. Rosenstock IM. Why people use health services. Milbank Mem Fund Q. 1966;44(Suppl):94–127.
    1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice-Hall Series in Social Learning Theory. Englewood Cliffs: Prentice-Hall Inc; 1986.
    1. Glanz K, Rimer BK, Viswanath KV. Health Behavior and Health Education: Theory, Research and Practice. 3. Jossey-Bass: San Francisco; 2002.
    1. Minkler M. In: Health Behavior and Health Education: Theory, Research and Practice. 4. Glanz K, Rimer BK, Lewis FM, editor. Piscataway NJ: Rutgers University Press; 2008. Improving health through community organization and community building; pp. 279–311.
    1. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Ann Rev Pub Health. 1998;19:173–200. doi: 10.1146/annurev.publhealth.19.1.173.
    1. Israel BA, Schulz AJ, Parker EA, Becker AB, Allen AJ, Guzman JR. In: Community Based Participatory Research for Health. Minkler M, Wallerstein N, editor. San Francisco: Jossey-Bass; 2003. Critical issues in developing and following community based participatory research principles; pp. 53–76.
    1. Israel BA, Eng E, Schulz AJ, Parker EA. Methods in Community-Based Participatory Research for Health. San Francisco: Jossey-Bass; 2005.
    1. Minkler M. Ethical challenges for the “outside” researcher in community-based participatory research. Health Educ Behav. 2004;31:684–697. doi: 10.1177/1090198104269566.
    1. Smith L, Bratini L, Chambers DA, Jensen RV, Romero L. Between idealism and reality: meeting the challenges of participatory action research. Action Res. 2010;8:407–425. doi: 10.1177/1476750310366043.
    1. Lohan TG, Roche AF, Martorell R. Anthropometric Standardization Reference Manual. Champaign: Human Kinetics Publishers; 1988.
    1. Arroyo M, Freire M, Ansotegui LA, Rocandio M. Intraobserver error associated with anthropometric measurements made by dietitians. Nutr Hosp. 2010;25:1053–1056.
    1. Food security in the United States: measuring household food security. .
    1. Kaiser LL, Melgar-Quinonez H, Townsend MS, Nicholson Y, Fujii ML, Martin AC, Lamp CL. Food insecurity and food supplies in Latino households with young children. J Nutr Educ Behav. 2003;35:148–153. doi: 10.1016/S1499-4046(06)60199-1.
    1. Kaiser LL, Metz DL, Nicholson Y, Fujii ML, Lamp CL, Townsend MS, Crawford PB, Melgar-Quiñonez HR. Food insecurity prominent among low-income California Latinos. Calif Agric. 2004;58:18–23. doi: 10.3733/ca.v058n01p18.
    1. Melgar-Quinonez HKL, Martin AC, Metz D, Olivares A. Food insecurity among Californian Latinos: focus-group observations. Salud publica de Mexico. 2003;45:198–205. doi: 10.1590/S0036-36342003000300009.
    1. Vera-Becerra L. Childhood Obesity in Mexican-Origin Populations. University of California, Davis: Graduate Group in Nutritional Biology; 2012. (PhD dissertation).
    1. Hughes SO, Anderson CB, Power TG, Micheli N, Jaramillo S, Nicklas TA. Measuring feeding in low-income African-American and Hispanic parents. Appetite. 2006;46:215–223. doi: 10.1016/j.appet.2006.01.002.
    1. National Longitudinal Survey of Youth 1979 cohort, 1979–2010 (rounds 1–22) .
    1. Children of the NLSY79, 1979–2010. .
    1. Current Population Survey.
    1. National Health and Nutrition Examination Survey Questionnaire. .
    1. Chaidez V. Toddler Feeding Practices in Latinos: An Early Start in Obesity Prevention. University of California, Davis: Graduate Group in Nutritional Biology; 2009. (PhD dissertation).
    1. Cuellar I, Arnold B, Maldonado R. Acculturation rating scale for Mexican Americans-II: a revision of the original ARSMA scale. Hisp J Behav Sci. 1995;17:275–304. doi: 10.1177/07399863950173001.
    1. Virtanen P, Kinnunen H. Polar Active - Activity Monitor for Children and Adolescents. Polar R&D Physiological Research; 2010.
    1. Kieffer EC, Salabarría-Peña Y, Odoms-Young AM, Willis SK, Baber KE, Guzman JR. In: Methods in Community-Based Participatory Research. Israel BA, Eng E, Schulz AJ, Parker EA, editor. San Francisco: Jossey-Bass; 2005. The application of focus group methodologies to community-based participatory research; pp. 146–147.
    1. Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics. 2007;120:S229–53. doi: 10.1542/peds.2007-2329E.
    1. McKenzie T, Sallis JF, Rosengard P. Beyond the stucco tower: design, development, and dissemination of the SPARK physical education programs. Quest. 2009;61:114–127. doi: 10.1080/00336297.2009.10483606.
    1. SPARK K-2 PE Curriculum.
    1. Dowda M, James F, Sallis JF, McKenzie TL, Rosengard P, Kohl HW. Evaluating the sustainability of SPARK physical education: a case study of translating research into practice. Res Q Exerc Sport. 2005;76:11–19.
    1. Prosper MH, Moczulski VL, Qureshi A, Weiss M, Bryars T. Healthy for life/pe4me: assessing an intervention targeting childhood obesity. Californian J Health Promot. 2009;7
    1. Johnston CA, Tyler C, Fullerton G, McFarlin BK, Poston WS, Haddock CK, Reeves RS, Foreyt JP. Effects of a school-based weight maintenance program for Mexican-American children: results at 2 years. Obesity (Silver Spring) 2010;18:542–547. doi: 10.1038/oby.2009.241.

Source: PubMed

3
Subscribe