Acceptability and appropriateness of a novel parent-staff co-leadership model for childhood obesity prevention in Head Start: a qualitative interview study

Abstract

Background Peer leadership can be an effective strategy for implementing health programs, benefiting both program participants and peer leaders. To realize such benefits, the peer leader role must be appropriate for the community context. Also, peer leaders must find their role acceptable (i.e., satisfactory) to ensure their successful recruitment and retention. To date, parent peer leaders have seldom been part of early childhood obesity prevention efforts. Moreover, parents at Head Start preschools have rarely been engaged as peer leaders. The aim of this study is to evaluate the appropriateness and acceptability of an innovative model for engaging parents as peer leaders for this novel content area (early childhood obesity prevention) and setting (Head Start). Methods Parents Connect for Healthy Living (PConnect) is a 10-session parent program being implemented in Head Start preschools as part of the Communities for Healthy Living early childhood obesity prevention trial. PConnect is co-led by a parent peer facilitator who is paired with a Head Start staff facilitator. In the spring of 2019, 10 PConnect facilitators participated in a semi-structured interview about their experience. Interview transcripts were analyzed by two coders using an inductive-deductive hybrid analysis. Themes were identified and member-checked with two interviewees. Results Themes identified applied equally to parent and staff facilitators. Acceptability was high because PConnect facilitators were able to learn and teach, establish meaningful relationships, and positively impact the parents participating in their groups, although facilitators did express frustration when low attendance limited their reach. Appropriateness was also high, as PConnect provided adequate structure and support without being overly rigid, and facilitators were able to overcome most challenges they encountered. Conclusions The PConnect co-facilitation model was highly acceptable and appropriate for both the parent facilitators (peer leaders) and the staff facilitators. Including parents as peer leaders aligns to Head Start’s emphasis on parent engagement, making it a strong candidate for sustained implementation in Head Start. The insights gained about the drivers of peer leadership appropriateness and acceptability in this particular context may be used to inform the design and implementation of peer-led health programs elsewhere. Trial registration clinicaltrials.gov, NCT03334669 (7–11-17).

How do Central American Parents in the United States View the Importance of and Obtain Information About Behaviors Associated with the Risk of Early Childhood Obesity?

“…It is possible that fewer foreign-born parents reported a preference to obtain information from other parents due to having a smaller close and trusted network of peer parents in the United States. Substantiated by prior research, our findings have implications for health education and behavioral interventions and suggest the potential of a peer parent-led approach by engaging individuals who share a similar experience and sociocultural backgrounds with the priority population as agents of health education and promotion (Beckerman-Hsu et al, 2021;Foster et al, 2019;Kåks & Målqvist, 2020;Munns et al, 2016;Nikolaus & Nickols-Richardson, 2017;Yin et al, 2019).…”

“…Taken together, our findings about parents' top preferred sources of information suggest the potential of home-and community-based health education and behavioral interventions using a peer parent-led approach by individuals who share a similar experience and sociocultural backgrounds with the priority population (Beckerman-Hsu et al, 2021;Foster et al, 2019;Kåks & Målqvist, 2020;Munns et al, 2016;Nikolaus & Nickols-Richardson, 2017). Trained peer parent health educators could serve as important peer leaders for providing home-based health education and reinforcement of public health recommendations related to EBRBs endorsed by health care professionals such as pediatricians and WIC professionals (Beckerman-Hsu et al, 2021;Davis et al, 2017).…”

“…Taken together, our findings about parents' top preferred sources of information suggest the potential of home-and community-based health education and behavioral interventions using a peer parent-led approach by individuals who share a similar experience and sociocultural backgrounds with the priority population (Beckerman-Hsu et al, 2021;Foster et al, 2019;Kåks & Målqvist, 2020;Munns et al, 2016;Nikolaus & Nickols-Richardson, 2017). Trained peer parent health educators could serve as important peer leaders for providing home-based health education and reinforcement of public health recommendations related to EBRBs endorsed by health care professionals such as pediatricians and WIC professionals (Beckerman-Hsu et al, 2021;Davis et al, 2017). Previous peer-led home visiting parenting support programs implemented with ethnic minority populations, including multiethnic Latinx parents, have shown promising results in promoting positive changes in parenting attitudes, beliefs, and behaviors (Beckerman-Hsu et al, 2021;Foster et al, 2019;Kåks & Målqvist, 2020;Munns et al, 2016;Nikolaus & Nickols-Richardson, 2017;Quick et al, 2021).…”

“…Trained peer parent health educators could serve as important peer leaders for providing home-based health education and reinforcement of public health recommendations related to EBRBs endorsed by health care professionals such as pediatricians and WIC professionals (Beckerman-Hsu et al, 2021; Davis et al, 2017). Previous peer-led home visiting parenting support programs implemented with ethnic minority populations, including multiethnic Latinx parents, have shown promising results in promoting positive changes in parenting attitudes, beliefs, and behaviors (Beckerman-Hsu et al, 2021; Foster et al, 2019; Kåks & Målqvist, 2020; Munns et al, 2016; Nikolaus & Nickols-Richardson, 2017; Quick et al, 2021).…”