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Results Of A Multi-Level Intervention To Prevent And Control Childhood Obesity Among Latino Children: The Aventuras Para Ni\u00f1os Study <\/p>\n
Richard Stepney
UGAC
HPR 460: Analysis of Health Research
Dr. Qiana Amos
February 1, 2022 <\/p>\n
Globally, childhood obesity is one of the rising health issues. The increased prevalence of obesity has led to children developing certain diseases such as diabetes later in life. Within the children population, 32 % are overweight with more than 17 % being obese (Crespo et al., 2012). \u00a0According to Crespo et al., (2012), Latinos have a higher risk of becoming obese in comparison to non- Hispanic blacks and whites. The increased risk among Latinos has been necessitated by various factors such as consumption of calorie-dense foods including sugar-sweetened beverages, low physical activity, nutrient-poor foods, and high sedentary behavior. Moreover, instead of undertaking physical activity Latino children have a preference of utilizing most time watching television, which leads to higher BMI levels, an increase in body fat, and great consumption of calorie foods.\u00a0 Generally, the increased prevalence of obesity is due to modified behavioral changes, diet, and physical activity. <\/p>\n
Hypothesis<\/p>\n
The research study was purposely conducted to differentiate the effects of changes of school\/ community environments and home\/family environs (combined or independent intervention) in the avoidance and control of childhood obesity among Latinos. In the scope of the study, there were several proposed hypotheses such as the combined involvement would lead to increased physical activity and healthier dietary habits among these children as compared to the behavioral differences of the children in other sets ups. Moreover, another hypothesis constitutes that change in the children’s health behaviors was mainly influenced by the parental healthy changes. More so, in the completion of the three-year intervention children who received both interventions (home\/ family environment and school\/community environment) would attain lower BMI z- scores in comparison to the children in the other interventions ( Crespo et al., 2012). \u00a0According to the hypothesis, it is quite certain that childhood obesity is because of behavioral changes in parental care, diet, social health care, and physical activity. <\/p>\n
Methodology<\/p>\n
Independent and combined effects of the family\/ home (Fam-only) environmental changes, School\/ community (Comm-only) environmental changes, and control condition (no treatment) interventions were applied to evaluate the rate of preventing obesity among the Latino children (Crespo et al., 2012). \u00a0In the set up the family involvement was specifically for the home environment while the community involvement was for the community and the school surroundings through the creation of social and physical differences. The interventions were documented in order to understand the relationship between the change in health behaviors and childhood obesity. The outcomes targeted primarily the BMI z- score, and secondarily behavioral changes such as sedentary behavior, child-eating habits, and physical activity. In the Fam- only intervention the parental-related health behavioral changes were the main target.\u00a0 <\/p>\n
Within the Fam- Only involvement, the promotors (community leaders) followed a specific curriculum, which had knowledge about Applied Behavioral Analysis and Latino population studies to deliver information to the families and for training. The promotors visited the families and discussed issues such as decreasing the time spent on watching TV, increasing intake of water, fruits, and vegetables, an increase of exercise activities, and reducing consumption of beverages (sugar-sweetened) beverages.\u00a0 In addition, in the Commonly involvement targeted healthy menu for children in the restaurant, social policies and structures e.g. classroom practices, physical structure such as salad bars, physical education, and media messages which are culturally acceptable e.g. posters about grocery stores. The environmental changes focused on the adults\u2019 majorly local government officials, teachers, and grocery store and restaurant owners who were directly involved in the life of the child when away from home. Whereas in the untreated control condition, parents and children were left to continue with their normal lifestyle and dietary habits. <\/p>\n
Sampling method<\/p>\n
The research employed the Aventuras para Ni\u00f1os (APN) study method. In this method, there were randomized trials that took three years in a 2 by 2 factorial design. The trial involved thirteen schools riffled to either one of the conditions: Fam-only change, Fam and Comm change, and Comm-only change, and a control condition. The eligibility of the 13 schools involved the following:\u00a0 no magnet schools ( no charter and boundary to a defined attendance), at least 70 % enrollment of Latinos, teachers who have not received any physical education training in the last four years, and no other related health program ( Crespo et al., 2012). \u00a0More so, the eligibility criteria for the families were: has a child in first or second-grade kindergarten in one of the selected 13 schools, self-identified as Latino, resided within the school attendance boundaries, children with minor health problems, and a family, which intends to reside within the school boundaries for at least a year. <\/p>\n
Promotoras were selected via schools to ascertain that they had adequate information about the environs. 8 promotors who were selected were mainly fit for the following criteria; literate with a grade 8 level and able to speak and write Spanish, female gender, one-year commitment to the project, and availability of individual transportation. APN study design, clearly made schools as the randomized units while the unit of analysis was the children who participated. <\/p>\n
Measurement methods <\/p>\n
Calculation of the child (BMI z-sore and percentile) and parents’ BMI was done according to the standard anthropometric measures; digital scale and portable stadiometer were used to measure their height and weight. These measurements were used for reliability measurements. The physical activity of the children was evaluated according to a 1-5 scale of the parents\u2019 response. In addition, the children’s sports involvement and active transportation to and from school by either riding a bicycle or walking were evaluated by the parents\u2019 responses. Behavioral dietary changes which include reduced consumption of fat and increased intake of fiber was measured with a scale that gives a predictive validity. More so, parents were asked open and close-ended questions on certain demographic variables such as employment status, household income, level of education, child age and gender, and marital status. <\/p>\n
Ethical considerations<\/p>\n
The program should involve people from all demographic statuses without bias, e.g. male and female children, employed and unemployed parents. Social policies made should include health messages that promote increased consumption of fruits and vegetables. <\/p>\n
Conclusion<\/p>\n
Conclusively, research about the effects of the independent and combined multilevel factors has increased the understanding of the impact of environmental and behavioral changes on the control and prevention of childhood obesity. Change of parenting styles and environmental changes (community, school, and local government policies) has had a great secondary outcome on the children\u2019s physical activity and healthy eating behavior.<\/p>\n
Limitations<\/p>\n
The research has limitations in the measurement methods. One of the measurements methods includes self-report surveys such as child physical activity and reduced TV watching which is often prone to self-bias. In comparison to objective measures, a self-report survey does not give a predictive validation, thus limitations in determining the conclusive effects of the intervention. More so, the survey excluded a measure of social desirability that is significant for adjusting the analysis. <\/p>\n
References<\/p>\n
Crespo, N. C., Elder, J. P., Ayala, G. X., Slymen, D. J., Campbell, N. R., Sallis, J. F., … & Arredondo, E. M. (2012). Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the Aventuras Para Ni\u00f1os Study.\u00a0Annals of Behavioral Medicine,\u00a043(1), 84-100.<\/p>\n","protected":false},"excerpt":{"rendered":"
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