Reducing Obesogenic Eating Behaviors in Hispanic Children through a Family-Based, Culturally-Tailored RCT: Abriendo Caminos

Abstract

Family-based interventions that incorporate culturally-tailored multi-component curricula and are grounded on evidence-based information and theoretical frameworks can help reduce the prevalence of obesity among Hispanic children. Abriendo Caminos: Clearing the Path to Hispanic Health is a multi-site culturally-tailored randomized control trial that aims to reduce obesity rates in Hispanic families by delivering education on nutrition, family wellness, and physical activity. This study evaluated the effect of the Abriendo Caminos six-week intervention on dietary behaviors of Hispanic children (6–18 years). Mothers (n = 365) reported their child’s eating behavior intake using the U.S. Department of Education’s Early Childhood Longitudinal Study protocol (ECLS). Pre/post dietary changes were evaluated using separate generalized estimating equation models adjusted for site, child sex, and child age group. Findings indicate a reduction in the frequency of sugar-sweetened beverages (OR 0.55, 95% CI 0.35, 0.87, p = 0.01), French fries (OR 0.56, 95% CI 0.36, 0.86, p = 0.009), and fast food (OR 0.55, 95% CI 0.36, 0.84, p = 0.006) consumption among children in the intervention arm. Additionally, children in the intervention arm increased their frequency of vegetable consumption (OR 1.84, 95% CI 1.08, 3.12, p = 0.03). The Abriendo Caminos intervention effectively improved four of eight eating behaviors in a short-term intervention.

The Effect of Family-Based Empowerment in Preventing Overweight and Obesity in Elementary School Children in Kupang

“…10 The causes of obesity are multifactorial and include interactions between eating behavior (eg, frequency, amount, and occasion of eating), food intake (eg, dietary pattern and food components), physical activity, obesogenic environment, and genetics. 11 The immediate cause of obesity is the accumulation of excess fat in the body due to increased energy intake in relation to energy requirements. However, the imbalance between the energy value of food and energy expenditure is related to biological, social, cultural, political, local and global economic factors.…”

Nutrition Effects of a Family-Centered Health Promotion Program for Mexican-Heritage Children in the Lower Rio Grande Valley of Texas

“…A larger sample size would have improved precision of estimates and may have provided sufficient power to detect statistically significant effects. The program was relatively shorter than other programs (duration six weeks to 16 weeks) [ 3 , 7 , 59 , 60 , 61 , 62 ], but more comprehensive and intensive. For example, the program included family functioning, nutrition, and physical activity and was intense, with a greater dose (900 min or 15 h) compared to previous programs with a similar focus (range for dose: 10.5 to 20 h) over a shorter six-week duration (range: 6 to 12 weeks) [ 12 ].…”

“…There is an opportunity for health promotion to support nutrition and physical activity for Latino/a children living in limited-resource households and rural communities, including Texas–Mexico border communities, but few nutrition interventions or programs have been designed, implemented, or evaluated for this population. Exemplar interventions for Latino/a children include Crespo et al, Davis et al, and Barragan et al [ 5 , 6 , 7 ]. Prior research has documented the importance of strengths-based and culturally relevant approaches for experiential nutrition education interventions or programs [ 8 ].…”

Randomized control trial of a childhood obesity prevention family-based program: “Abriendo Caminos” and effects on BMI

“…Unfortunately, this is a common problem in health promotion programs designed and implemented among underserved and ethnically diverse groups. Immediate incentives, regular reminders, and engaging activities were integral elements of the program ( 22 , 28 ). Retention was lower than we expected, due to the family/work demands and high mobility of the population.…”

“…We used a simple Spanish linguistic structure with the concept “ más ,” “ menos ,” or “ más o menos ” (more, less, or in between) integrated into lessons to focus on small changes to increase healthier lifestyles and reduce negative or restrictive behaviors ( 22 ). The intervention program included workshops with three components (30 min of nutrition education, 30 min of family wellness education, and 60 min of physical activity), with extensive details published before ( 19 , 22 , 28 ). At the end of each session, parents completed an evaluation of the workshop and received a gift card for their attendance.…”