Community Active and Healthy Families: Family-Centered Obesity Treatment for Latino Children

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PROJECT SUMMARY/ABSTRACT Effective, family-oriented childhood weight management interventions for Latinos are critical in order to decrease lifetime cardiovascular disease (CVD) risk that stems from childhood obesity. Childhood obesity is a risk factor for adult CVD, the leading cause of death in the US. One in four US children is Latino, and Latino children have among the highest childhood obesity rates of any US racial/ethnic group. US-born Latino children of immigrant parents comprise half of US Latino children and experience higher overweight/obesity rates than other Latino children. The US Preventive Services Task Force recommends referral of all obese children to an intensive weight management program to prompt behavior changes to decrease body mass index (BMI). Intensive programs are mainly found in clinical settings, are limited in number and are frequently impractical for Latino immigrant families. Reducing obesity disparities for Latino children in immigrant families requires addressing the current lack of evidence-based obesity treatment programs that are tailored to their sociocultural needs and delivered at a feasible intensity. The proposed research addresses this gap via the Community-Active and Healthy Families (Community-AHF) program. Community-AHF is a behavioral-theory based, culturally tailored, Spanish-language weight management program for 5-12 year old overweight/obese Latino children and their families. Community-AHF was adapted from a group visit weight management program delivered in healthcare settings that demonstrated effectiveness in reducing child BMI for Latino children in low-income immigrant families. Previously, stakeholders were engaged to identify adaptations to retain key components while accounting for the change in delivery setting using intervention mapping. To prepare to implement Community-AHF we will use a related process-implementation mapping. A key area of focus for implementation mapping will be on the equitable distribution of power and knowledge between the academic team and the community organizations delivering the intervention. Subsequently, a Hybrid Type II Implementation/Effectiveness trial will be conducted to simultaneously evaluate the effectiveness of Community-AHF at reducing child BMI using a pragmatic randomized controlled trial and its implementation using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Community- AHF will be implemented in two Latino immigrant communities, one emerging and one established, in partnership with Latino-immigrant serving community organizations. Common and distinct challenges from implementation in key typologies of Latino immigrant communities will inform future scaling. Findings from this study will address a gap in knowledge about the implementation processes and strategies that are effective in reaching implementation outcome goals and that support and sustain equitable community partnerships and our findings will strengthen the evidence-base for weight management for Latino children in immigrant families whose disproportionately high rates of childhood overweight/obesity increase their lifetime CVD risk.