Cultural Relevance of the Healthy Choices Intervention Program

Background: The burden of obesity and its health consequences disproportionately affects Hispanic children and families. In Arizona, nearly 18% of the state’s children and adolescents are obese (up from 12.2% in 2003) with the rate rising by nearly 46% between 2003 and 2007. Researchers have determined that multi-component; comprehensive obesity interventions are feasible in the primary care setting. In addition, it has become evident that intervention effectiveness is improved when obesity interventions are individualized to address the family’s social and cultural influences on health.

Purpose: The purpose of this study was to determine the acceptability, applicability and cultural relevance of the Healthy Choices Intervention (HCI) program for underserved, Hispanic overweight and obese 9 to 12 year old children and their parents who utilize the healthcare services at an inner city pediatric primary care clinic. This study was funded by a 2012 Sigma Theta Tau International Small Grant.

Methods:

Research Design

            Phase 1. The preliminary efficacy of the HCI with overweight and obese 9-12 year old Hispanic children (N=20) and their parents/legal guardians (N=20), recruited from a clinic that delivers health care to the medically underserved was evaluated utilizing a quasi-experimental design.

            Phase 2. A descriptive qualitative design, utilizing parent and child focus groups, informed as to the acceptability and cultural relevance of the HCI.

Outcomes Measured

            Demographics, anthropometrics and self-reported measures of beliefs, behaviors and psychosocial functioning were obtained.

Results: The parents and children reported high acceptability and applicability of the HCI. Parental feedback included recommendations pertaining to the cognitive skills building activities and nutritional content of the intervention.

Conclusion: Incorporating feedback from the participants strengthened the HCI.  The HCI has been now been adapted, not only to be culturally relevant to the Hispanic families, but also addresses the current recommendations for comprehensive obesity management in primary care settings.