Objectives: The long term goal of this project is to evaluate the efficacy and feasibility of an integrated approach to reduce pediatric obesity in low income Spanish speaking families with preschool age children by validating two obesity risk assessment tools and one diet quality tool and determining the feasibility of EFNEP embedded in a medical clinic.
Description: Participant recruitment and data collection (parental surveys; 24-hour dietary, sleep, activity logs; anthropometric and biomarker measures; and mealtime video recordings) to validate the tools continued to be the focus of year 3 (Y3). Pilot testing of the medical clinic kiosk commenced to stimulate parent interest and physician referrals to the EFNEP classes.
Evaluation: One hundred parent-child pairs from 12 Head Start and WIC sites were enrolled in Y3 for a total of 210 participants enrolled. More than 30% of the children were overweight. Children with higher BMI percentiles-for-age had significantly higher plasma cholesterol, LDL-C and nonHDL-C levels compared to children with lower BMI-percentiles for age. Twenty-one new videotapes were collected to assist with validation of the parenting tool. Content and face validity of the Spanish diet quality tool were achieved after applying a multistep, iterative process that included four rounds of cognitive interviews. Twelve iPad kiosk pilot testing sessions were completed demonstrating the need for clinic wait times of >5 minutes and handing the iPad directly to the parent to enhance usage. Physicians (n = 81) generated 425 patient referrals, of which 227 were in Y3. Thirty-one parents were enrolled in the EFNEP intervention in Y3 for a total 69 parents with 83% completing 5 or more classes. Parents (84%) identified physician referral as an important reason for enrolling.
Conclusions and Implications: Obesity risk assessment and diet quality tools for Spanish speaking families are being validated and an iPad kiosk and EFNEP intervention are being implemented in several medical clinics. These outcomes are intended to promote clinical intervention before children become overweight to establish a new trajectory of weight gain.
The following is the supplementary data to this article: