Background
Over 20% of Latino youth in the US are considered obese. Culturally adapted interventions that address the physical, social, and environmental influences on physical activity and diet are needed to help reduce health disparities in Latino youth. However, there is often a lack of understanding among researchers about how to tailor interventions to positively reach these communities. Community-Engaged Research (CEnR) can bridge this gap. This poster highlights lessons learned from The Healthy Activities Partnership Program for Youth (HAPPY), an ongoing intervention to promote healthy nutrition, physical activity, and media literacy among Latino children.
Description
The HAPPY intervention is a partnership between the United Community Center and the University of Wisconsin School of Medicine and Public Health. Intervention design was guided by results from a previous pilot study, which analyzed individual, social, and environmental barriers to physical activity and healthy eating among Latino children (age 10-14) enrolled in UCC's Bruce-Guadalupe Community School (BGCS). Results indicated that there was a strong need for a multilevel intervention. The percentage of overweight children (n=190) in the pilot study was 52%, significantly higher than the national average (39%). The study found that higher body-mass index (BMI) values were associated with higher sugar intake and among those living on streets with heavy traffic. Despite the availability of fresh-food alternatives, almost all food trips made by children in the study were to convenience stores. The children explained the importance of snack foods for socializing. Children in the study whose parents paid more attention to their children’s diet and physical activity had lower BMI values, indicating that family support is a crucial component of a successful intervention program. The team worked together to develop a culturally appropriate intervention combining three components: enhanced physical activity curriculum, school and home-based nutrition education, and a media literacy/neighborhood environmental assessment class. The intervention was designed to improve (1) individual knowledge, skill and self-efficacy, (2) peer and family support, (3) media literacy, and (4) neighborhood support.
Lessons Learned
Establishing trust in CEnR takes time and hinges primarily on the involvement of all parties during all phases of research. Successful interventions are built on research results that are interpreted by both sides of the partnership. However, this does not guarantee success. The first year of the HAPPY intervention concluded in July 2014 and the team noted a number of challenges. · Identified Organizational Barriers Barriers were identified from within UCC’s organizational system that interfered with delivery of the intervention. (1) Another childhood obesity prevention research study was also being conducted at BGCS, which competed for recruits. (2) BCGS’s strong after school program lowered recruitment levels and created attendance difficulties for children who enrolled in HAPPY. (3) Lack of indoor recreation space during winter months limited the physical activity opportunities. · Qualitative Retention Barriers Students were generally pleased with the program and expressed appreciation for the class. One student stated, “I went to a fast food restaurant with my family and chose a salad instead of getting a hamburger and fries.” Another said, “I’m shocked by how many calories my favorite snacks have.” However, many experienced barriers to participation and translating what they learned in class to their everyday life. For example, students stated that they did not walk or ride their bikes, even though they had learned that these were healthy activities, because of real or perceived dangers in their neighborhoods, including high traffic volume, concerns about crime, and worries about sexual predators. We also learned from parents that there are many unpredictable barriers to participation including miscommunication between the child and the parent, unexpected lack of transportation, and the need to have a participating student stay at home to care for younger siblings.
Conclusions
CEnR has the potential to significantly increase the success of physical activity and healthy eating interventions for children. The HAPPY intervention will include students, parents and school administrators in planning changes to years two and three in order to address barriers to participation.
Next Steps
The HAPPY project will continue for two more years. Findings will be disseminated through presentations, publications, and to state and local education policy makers. Lessons learned will be incorporated into a curriculum guide that will support project duplication through other Latino serving community organizations.
Support / Funding Source
HAPPY 1: 2010 Wisconsin Partnership Program (WPP); Partnership Education and Research Committee; University of Wisconsin School of Medicine and Public Health (PI: Aaron Carrol, MD and David Allen, MD) HAPPY 2: 2012 Wisconsin Partnership Program (WPP); Community-Academic Partnership Implementation Grant; University of Wisconsin School of Medicine and Public Health (PI: Samuel F Dennis Jr, PhD, Community Partner: Al Castro, MS, United Community Center).
