The Healthy Children, Strong Families Intervention: Design and Community Participation
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RESEARCH METHODS AND PRACTICE
The Healthy Children, Strong Families Intervention: Design and Community Participation Alexandra K. Adams • Tara L. LaRowe • Kate A. Cronin Ronald J. Prince • Deborah P. Wubben • Tassy Parker • Jared B. Jobe
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Published online: 7 September 2012 Ó Springer Science+Business Media, LLC 2012
Abstract Healthy Children, Strong Families (HCSF) is a 2-year, community-driven, family-based randomized controlled trial of a healthy lifestyles intervention conducted in partnership with four Wisconsin American Indian tribes. HCSF is composed of 1 year of targeted home visits to deliver nutritional and physical activity curricula. During Year 1, trained community mentors work with 2–5-year-old American Indian children and their primary caregivers to promote goal-based behavior change. During Year 2, intervention families receive monthly newsletters and attend monthly group meetings to participate in activities designed to reinforce and sustain changes made in Year 1. Control families receive only curricula materials during Year 1 and A. K. Adams (&) T. L. LaRowe K. A. Cronin R. J. Prince Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Ct., Madison, WI 53715, USA e-mail: [email protected] D. P. Wubben Physicians Plus Insurance, Corp, Madison, WI, USA T. Parker Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA J. B. Jobe Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA e-mail: [email protected]; [email protected]
monthly newsletters during Year 2. Each of the two arms of the study comprises 60 families. Primary outcomes are decreased child body mass index (BMI) z-score and decreased primary caregiver BMI. Secondary outcomes include: increased fruit/vegetable consumption, decreased TV viewing, increased physical activity, decreased soda/sweetened drink consumption, improved primary caregiver biochemical indices, and increased primary caregiver self-efficacy to adopt healthy behaviors. Using community-based participatory research and our history of university–tribal partnerships, the community and academic researchers jointly designed this randomized trial. This article describes the study design and data collection strategies, including outcome measures, with emphasis on the communities’ input in all aspects of the research. Keywords Obesity American Indian Nutrition Physical activity Intervention
Introduction Similar to obesity trends in American Indian (AI) adults, obesity rates in AI children are steadily increasing and are higher than those in all other racial/ethnic groups combined in the United States. The Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance System estimates that AI children (ages 2–5 years) have the highest rates for overweight and obesity (40 %)
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among children of all racial/ethnic groups (31.2 %) (CDC, 2009). Moreover, the prevalence rate has
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