Expanding Family-based Obesity Treatment Interventions for Children in Emerging Latinx Communities: A Qualitative Evaluation

Background: Latinx children have the highest childhood overweight and obesity rates out of any United States racial and ethnic group. The United States Preventative Task Force recommends pediatric obesity screening and referral to comprehensive, intensive behavioral interventions. However, there is a lack of data for obesity treatment programs for newly developing (emerging) Latinx communities that often have fewer social supports in place compared to more established Latinx communities. Qualitative evaluations of obesity treatment programs for Latinx youth are also limited.

Methods: Forty Latinx children aged 5-12 years old who were overweight or obese were recruited into a community-based, family-oriented obesity treatment program in an emerging Latinx community. The program was based on the Active and Healthy Families (AHF) intervention initially implemented in California. Our program, which ran from September 2017 to September 2019, consisted of eight in-person group sessions over sixteen weeks led by a nutritionist, pediatrician, and promotora. All the parents who participated with their children in the intervention were invited to be interviewed. For those parents who consented, interviews were conducted from December 2020 to February 2021 to explore their experience during and post intervention as well as the impact of the COVID-19 pandemic on family behaviors. Transcripts were recorded, transcribed, and analyzed for thematic content. Transcripts were coded independently using Dedoose and subsequently reconciled with a second coder. The coding team reviewed the codes and selected the themes through group consensus. This project was approved by our institutional IRB (IRB00136080).

Results: We interviewed 14 mothers. Four major themes emerged: 1) mothers’ felt a sense of responsibility and desire to learn how to improve the health of their child, 2) families acquired new knowledge that they applied to change household habits, 3) parents felt solidarity with other parents in the program by sharing struggles and common experiences, and 4) the COVID-19 pandemic made it difficult to maintain dietary changes and active lifestyles. Further, parents were open to a virtual format for the intervention.

Conclusion: The family intervention was well received and created a supportive environment for parents. Based on the knowledge they gained through the intervention, parents endorsed behavior change at both the child and parent level following the program. However, social distancing measures as part of the COVID-19 pandemic response often reversed many of these behavior changes. These findings support the use of community-based, family-oriented pediatric obesity treatment programs in emerging Latinx communities. Additional quantitative analysis of this project to review intervention effectiveness is underway. Booster sessions may be needed to support families and provide strategies when new stressors and barriers arise such as such as those that occurred during the COVID-19 pandemic. Future studies could also investigate the acceptability and effectiveness of a virtual format for the intervention.