Pragmatic Pilot Study of the Healthy Living Program: An Obesity Prevention and Treatment Program for Low-Income Hispanic Families Delivered Through Clinic-Community Partnership.

BACKGROUND

Few childhood obesity interventions have been designed for Hispanic families including Spanish speakers. This pragmatic pilot study assessed the effectiveness of a whole-family obesity prevention and treatment program-the Healthy Living Program (HeLP).

METHODS

HeLP is delivered at recreation centers by teams of health educators and fitness professionals. HeLP involves 12 group sessions, including parenting, child feeding, nutrition, cooking, meal planning/shopping, and fitness. Primary care providers referred families of children 2 years and older with obesity. This pragmatic longitudinal study collected data at the intervention and from electronic health records to compare child BMI trajectories from 12 months pre- to 12 months postintervention, in terms of the percentage of the 95th percentile BMI (BMI%95) using hierarchical mixed-effects models to account for clustering and to adjust for age, sex, weight status, and language.

RESULTS

Median attendance was 8 of 12 sessions. Of 317 children who had BMI measured clinically 1 year prior to HeLP, 265 (84%) had BMI measured 1 year post-HeLP, including 210 with overweight or obesity and 55 healthy weight siblings. About 71% of parents spoke Spanish only. Changes in modeled BMI%95 trajectory for children with overweight or obesity were: -6.7% [95% CI -13.0%, -0.4%] (p = 0.04) for 2-6 years, -5.8% [-8.6%, -3.0%] (p < 0.0001) for 7-11 years, and -4.1% [-6.8%, -1.4%] (p = 0.003) for 12-18 years. Children with overweight decreased -4.6% [-8.4%, -0.9%] (p = 0.001).

CONCLUSIONS

These data suggest that HeLP, a whole-family intervention delivered by clinic-community partnership, may be effective at preventing and treating obesity in children from Hispanic families with low income and support an ongoing randomized controlled trial.