To address pediatric obesity risk reduction, EFNEP was embedded within medical clinics where pediatricians referred parents to the intervention. The traditional EFNEP intervention was augmented with guided goal setting (GGS), Healthy Kids (HK) obesity risk assessments, motivational modeling, and parenting topics. This investigation focused on assessing goal-setting behaviors of EFNEP participants attending the medical clinic intervention.
Pediatricians referred 686 parents (30% Spanish speaking) to the EFNEP intervention. More than one-third (n = 264) of parents referred expressed interest in attending with 195 verbally agreeing to enroll in the intervention anchored with GGS. GGS gives goal choices from a collection of practitioner developed major and minor goals so parents can make their own goal decisions. Parents completed the HK assessment tools during session one, they were guided to select nutrition and parenting minor goals at session two, but at subsequent sessions, were given the options to continue with the same goal, select a new guided goal, modify the existing goal, or create a new goal. Goal selections, effort, and attainment were tracked weekly.
Twenty intervention series with parents or caregivers (n = 105, 50% Spanish speaking) were conducted at five medical clinics with 78% of parents completing four or more sessions. All parents engaged in GGS with most making nutrition and parenting goal effort and achievement (Spanish 96%, 74%; English 92%, 69%, respectively). Parents selected fruit and vegetable goal topics frequently and rarely chose contingency management topics. Most parents selected a new goal each session with Spanish speaking parents more likely to select a guided option (72% vs 61%).
Conclusion and Implications
Parents referred by their child's pediatrician attended the EFNEP intervention and engaged in the GGS activities. Parents reported a high level of goal commitment with Spanish speaking parents attending more classes and reporting higher levels of goal effort compared to English speaking parents. GGS was shown to be a suitable behavioral strategy for Spanish and English speaking parents attending EFNEP within a medical clinic setting.