Research Methods| Volume 51, ISSUE 10, P1211-1219, November 2019

Download started.


Implementation and Evaluation of the Abriendo Caminos Program: A Randomized Control Trial Intervention for Hispanic Children and Families



      To describe the methodology of a family-focused, culturally tailored program, Abriendo Caminos, for the prevention of excess weight gain in children.


      Randomized control trial with outcome assessment at pretest, posttest, and 6 months after intervention or abbreviated-attention control group.


      Community setting across 5 sites (Illinois, California, Iowa, Texas, and Puerto Rico).


      Mexican American and Puerto Rican families (parent and 1 child aged 6–18 years). A sample size of 100 families (50 intervention and 50 control) per site (n = 500) will provide adequate power to detect intervention effects.


      Families will participate in 6 weekly, 2-hour group workshops on nutrition education through combined presentations and activities, family wellness, and physical activity.

      Main Outcome Measures

      The primary outcome is prevention of excess weight gain in children; secondary outcomes include changes in child diet, specifically fruit, vegetable, and sugar-sweetened beverage consumption, and changes in parents’ diets and improvement of family routines. Measures will be collected at baseline, postintervention, and 6 months after.


      Modeling to assess changes within and between experimental groups will be checked using standard methods including assessment of model fit, influence diagnostics, adjusted R2, and multicollinearity. Significance of effects will be examined using Type III tests.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.


      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ogden CL
        • Carroll MD
        • Lawman HG
        • et al.
        Trends in obesity prevalence among children and adolescents in the united states, 1988–1994 through 2013–2014.
        JAMA. 2016; 315: 2292-2299
        • Barkin SL
        • Gesell SB
        • Po'e EK
        • Escarfuller J
        • Tempesti T
        Culturally tailored, family-centered, behavioral obesity intervention for Latino-American preschool-aged children.
        Pediatrics. 2012; 130: 445-456
        • Cong Z
        • Feng D
        • Liu Y
        • Esperat MC
        Sedentary behaviors among Hispanic children: influences of parental support in a school intervention program.
        Am J Health Promot AJHP. 2012; 26: 270-280
        • Crespo NC
        • Elder JP
        • Ayala GX
        • et al.
        Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the aventuras para ninos study.
        Ann Behav Med Publ Soc Behav Med. 2012; 43: 84-100
        • Davis AM
        • Daldalian MC
        • Mayfield CA
        • et al.
        Outcomes from an urban pediatric obesity program targeting minority youth: the healthy hawks program.
        Child Obes (Print). 2013; 9: 492-500
        • Horton LA
        • Parada H
        • Slymen DJ
        • Arredondo E
        • Ibarra L
        • Ayala GX
        Targeting children's dietary behaviors in a family intervention: ‘Entre familia: reflejos de salud’.
        Salud Publ Mex. 2013; 55: 397-405
      1. Academy of Nutrition and Dietetics Evidence Analysis Library. Pediatric Weight Management: Interventions to Treat Pediatric Overweight (2006-2007). Cleveland, OH: Academy of Nutrition and Dietetics; 2019. Accessed May 15, 2019.

        • Raynor HA
        • Champagne CM.
        Position of the academy of nutrition and dietetics: interventions for the treatment of overweight and obesity in adults.
        J Acad Nutr Diet. 2016; 116: 129-147
        • Bandura A.
        Human agency in social cognitive theory.
        Ann Psychol. 1989; 44: 1175-1184
        • Mier N
        • Ory MG
        • Medina AA
        Anatomy of culturally sensitive interventions promoting nutrition and exercise in Hispanics: a critical examination of existing literature.
        Health Promot Pract. 2010; 11: 541-554
        • Zhou G
        • Gan Y
        • Hamilton K
        • Schwarzer R
        The role of social support and self-efficacy for planning fruit and vegetable intake.
        J Nutr Educ Behav. 2016; 49: 100-106
        • Diaz-Rios LK
        • Muzaffar H
        • Meline B
        • Chapman-Novakofski K
        Talk, heart, hands: A culturally sensitive approach to nutrition education for Latinos with young children.
        J Nutr Educ Behav. 2016; 48: 425-429
        • Wiggins G
        • McTighe J.
        Understanding by Design.
        2nd ed. Association for Supervision and Curriculum Development, Alexandria, VA1998
        • Linnell JD
        • Zidenberg-Cherr S
        • Briggs M
        • et al.
        Using a systematic approach and theoretical framework to design a curriculum for the shaping healthy choices program.
        J Nutr Educ Behav. 2016; 48: 60-69
        • Shaibi GQ
        • Konopken Y
        • Hoppin E
        • Keller CS
        • Ortega R
        • Castro FG
        Effects of a culturally grounded community-based diabetes prevention program for obese Latino adolescents.
        Diabetes Educ. 2012; 38: 504-512
        • Dollahite JS
        • Fitch C
        • Carroll J
        What does evidence-based mean for nutrition educators? Best practices for choosing nutrition education interventions based on the strength of the evidence.
        J Nutr Educ Behav. 2016; 48: 743-748
        • Janicke DM
        • Steele RG
        • Gayes LA
        • et al.
        Systematic review and meta-analysis of comprehensive behavioral family lifestyle interventions addressing pediatric obesity.
        J Pediatr Psychol. 2014; 39: 809-825
        • Kobel S
        • Lämmle C
        • Wartha O
        • Kesztyüs D
        • Wirt T
        • Steinacker JM
        Effects of a randomised controlled school-basedhealth promotion intervention on obesity related behavioural outcomes of children with migration background.
        J Immigr Minor Health. 2017; 19: 254-262
        • Ziebarth D
        • Healy-Haney N
        • Gnadt B
        • et al.
        A community-based family intervention program to improve obesity in Hispanic families.
        WMJ Off Publ State Med Soc Wis. 2012; 111: 261-266
        • Elder JP
        • Ayala GX
        • Parra-Medina D
        • Talavera GA
        Health communication in the latino community: issues and approaches.
        Annu Rev Public Health. 2009; 30: 227-251
        • Calzada EJ
        • Tamis-LeMonda CS
        • Yoshikawa H
        Familismo in Mexican and Dominican families from low-income, urban communities.
        J Fam Issues. 2013; 34: 1696-1724
        • Bender MS
        • Clark MJ
        • Gahagan S
        Community engagement approach: developing a culturally appropriate intervention for Hispanic mother–child dyads.
        J Transcult Nurs. 2014; 25: 373-382
        • Huang DY
        • Lanza HI
        • Anglin MD
        Trajectory of adolescent obesity: exploring the impact of prenatal to childhood experiences.
        J Child Fam Stud. 2014; 23: 1090-1101
        • Jones BL
        • Fiese BH
        • Kids Team STRONG
        Parent routines, child routines, and family demographics associated with obesity in parents and preschool-aged children.
        Front Psychol. 2014; 5: 374
        • Fiese BH
        • Hammons A
        • Grigsby-Toussaint D
        Family mealtimes: A contextual approach to understanding childhood obesity.
        Econ Hum Biol. 2012; 10: 365-374
        • Hammons AJ
        • Wiley AR
        • Fiese BH
        • Teran-Garcia M
        Six-week Latino family prevention pilot program effectively promotes healthy behaviors and reduces obesogenic behaviors.
        J Nutr Educ Behav. 2013; 45: 745-750
        • Kumpfer K
        • Magalhaes C
        • Xie J
        Cultural adaptation and implementation of family evidence-based interventions with diverse populations.
        Prev Sci Off J Soc Prev Res. 2017; 18: 649-659
        • Michie S
        • Ashford S
        • Sniehotta FF
        • Dombrowski SU
        • Bishop A
        • French DP
        A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the calo-re taxonomy.
        Psychol Health. 2011; 26: 1479-1498
        • Scherr RE
        • Linnell JD
        • Smith MH
        • et al.
        The shaping healthy choices program: design and implementation methodologies for a multicomponent, school-based nutrition education intervention.
        J Nutr Educ Behav. 2014; 46: 13-21
        • Codding RS
        • Feinberg AB
        • Dunn EK
        • Pace GM
        Effects of immediate performance feedback on implementation of behavior support plans.
        J Appl Behav Anal. 2005; 38: 205-219
        • Lyn R
        • Evers S
        • Davis J
        • Maalouf J
        • Griffin M
        Barriers and supports to implementing a nutrition and physical activity intervention in child care: directors' perspectives.
        J Nutr Educ Behav. 2014; 46: 171-180
        • Han E
        • Powell LM.
        Consumption patterns of sugar-sweetened beverages in the united states.
        J Acad Nutr Diet. 2013; 113: 43-53
      2. Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services.
        Washington, DC: US Department of Agriculture, 2010
        • Johnston CA
        • Moreno JP
        • Gallagher MR
        • et al.
        Achieving long-term weight maintenance in Mexican-American adolescents with a school-based intervention.
        J Adolesc Health Off Publ Soc Adolesc Med. 2013; 53: 335-341
        • Brannsether B
        • Eide GE
        • Roelants M
        • Bjerknes R
        • Juliusson PB
        BMI and BMI SDS in childhood: annual increments and conditional change.
        Ann Hum Biol. 2017; 44: 28-33
        • Reinehr T
        • Wabitsch M
        Childhood obesity.
        Curr Opin Lipidol. 2011; 22: 21-25
        • Hammons AJ
        • Hannon BA
        • Teran-Garcia M
        • et al.
        Effects of culturally tailored nutrition education on dietary quality of Hispanic mothers: a randomized control trial.
        J Nutr Educ Behav. 2019; 51: 1168-1176
        • Gans KM
        • Hixson ML
        • Eaton CB
        • Lasater TM
        Rate your plate: A dietary assessment and educational tool for blood cholesterol control.
        Nutr Clin Care. 2000; 3: 163-169
        • Musaad SM
        • Donovan SM
        • Fiese BH
        • Team SKR
        Parental perception of child weight in the first two years-of-life: A potential link between infant feeding and preschoolers’ diet.
        Appetite. 2015; 91: 90-100
        • Henderson JA
        • Jordan SS.
        Development and preliminary evaluation of the bedtime routines questionnaire.
        J Psychopathol Behav Assess. 2010; 32: 271-280
        • Bauman S.
        The reliability and validity of the brief acculturation rating scale for Mexican Americans-II for children and adolescents.
        Hisp J Behav Sci. 2005; 27: 426-441
        • Falbe J
        • Cadiz AA
        • Tantoco NK
        • Thompson HR
        • Madsen KA
        Active and healthy families: A randomized controlled trial of a culturally tailored obesity intervention for latino children.
        Acad Pediatr. 2015; 15: 386-395
        • Diaz Rios LK
        • Chapman-Novakofski K
        Latino/Hispanic participation in community nutrition research: an interplay of decisional balance, cultural competency, and formative work.
        J Acad Nutr Diet. 2018; 118: 1687-1699
      3. Allison PD. Handling missing data by maximum likelihood. Paper presented at: SAS Global Forum 2012 Conference; April 22–25, 2012; Orlando, FL. Accessed May 15, 2019.

        • Thompson DM
        • Fernald DH
        • Mold JW
        Intraclass correlation coefficients typical of cluster-randomized studies: estimates from the Robert Wood Johnson Prescription for Health projects.
        Ann Fam Med. 2012; 10: 235-240
        • Kahan BC
        • Morris TP
        Assessing potential sources of clustering in individually randomised trials.
        BMC Med Res Methodol. 2013; 13: 58
        • Kahan BC
        • Morris TP.
        Assessing potential sources of clustering in individually randomised trials.
        BMC Med Res Methodol. 2013; 13: 58
        • Wong H
        • Ouyang Y
        • Karim ME
        The randomization-induced risk of a trial failing to attain its target power: assessment and mitigation.
        Trials. 2019; 20: 360
        • Fiese BH.
        Family Routines and Rituals.
        1st ed. Yale University Press, New Haven, CT2006
        • Jacobs MP
        • Fiese BH.
        Family mealtime interactions and overweight children with asthma: potential for compounded risks?.
        J Pediatr Psychol. 2007; 32: 64-68
        • O'Connor C
        • Small SA
        • Cooney SM
        Program Fidelity and Adaptation: Meeting Local Needs Without Compromising Program Effectiveness.
        Madison, WI: University of Wisconsin Extension, 2007

      CHORUS Manuscript

      View Open Manuscript