Research Project
10304420
Project Summary Hispanics in the United States face health disparities for obesity and related medical conditions, such as cardiovascular disease and diabetes. Targeting families to promote healthy lifestyle behaviors has been identified as an effective strategy to prevent obesity. With the importance of familism (family cohesion) among the Hispanic population, a family based intervention is especially desirable as an engaging strategy to promote behaviors that support a healthy weight status and decrease obesity related health disparities for Hispanics. Emerging evidence supports the need to include and target fathers in family based lifestyle behavior interventions. However, to date mothers have almost exclusively been reached by such efforts in the US. Healthy Dads Healthy Kids (HDHK) is an evidence based program developed in Australia, shown to have significant weight and behavior treatment effects for fathers and their children, compared to controls. The HDHK program is based on Social Cognitive Theory and Family Systems Theory and aims to promote increased physical activity and improved dietary intake for fathers and their children. An important innovation in the program is that fathers and children attend together and are both targeted as agents of behavior change for each other (reciprocal reinforcement) and to participate in fun, family activities together. HDHK was culturally adapted for Hispanic families following the Ecological Validity Model by this research team, with input from a community Hispanic family panel, expert committee and the developer of the HDHK program. The resulting Papás Saludables, Niños Saludables (PSNS) program was tested for feasibility in a waitlist controlled RCT among 36 Hispanic families, whose child was a Texas Children?s Health Plan member. The findings support testing the culturally adapted program in a family randomized group trial with a standard of care comparison/ control for efficacy. The proposed efficacy trial is powered to detect a clinically meaningful change in father?s weight and children?s physical activity. The study will also assess other behavioral (dietary intake, sedentary time, screen media use, and parenting practices), psychosocial (familism, acculturation, and co-parenting alliance) and biological (non-HDL, HgbA1C, BP) outcomes. Partnership with the YMCA of Greater Houston offers a venue for where to deliver the program, and partnership with Texas Children?s Health Plan provides access to over 80,000 Hispanic children between the ages from 5-11 from which to recruit. The RE-AIM framework will inform a detailed process evaluation to assess barriers and facilitators to implementing PSNS with our community partners in the future. This novel lifestyle program can provide a paradigm shift for how obesity prevention for Hispanic children should be conceptualized, by directly engaging Hispanic fathers, which has not been done to date.
