Trans-community Approaches to Childhood Obesity Prevention and Treatment

Abstract

The Trans-community Approaches to Childhood Obesity Prevention and Treatment Study (Activa Y Sana) was a two-year (August 2006 to May 2008) intervention in one hundred and forty-one 3rd and 4th grade children and their parents from four schools in the Sunnyside School District in Tucson, Arizona. Activa was designed to expand upon schools as an intervention venue, and was the first to test the feasibility and impact of a multi-level, or "trans-community" approach (involving children, their parents or caregivers, schools, and community agencies) on the prevention of childhood weight gain in an at-risk Mexican-American population.Families were assigned to one of three interventions, depending upon which school the child attended: Level 1, state-mandated nutrition- and physical activity-based health curricula; Level 2, Level 1 curricula plus an after-school program; or Level 3, Level 1 + Level 2 activities, plus a family intervention.Primary endpoints of this study were changes in child BMI z-score, % fat, abdominal circumference, activity levels and food intake, psychosocial characteristics and correlates of these measures.The three manuscripts contained herein represent the main findings of this pilot study. Identifying potential mediators and describing their influence on childhood overweight is essential to development of successful interventions. In Study #1, the findings for the examination of correlates of child BMI z-score and % fat are reported. Activa Y Sana was designed to test whether combining different levels of intervention would have a greater impact on child weight. In Study #2, the results of this trans-community intervention on child weight status is discussed. The majority of evidence-based obesity prevention programs in use today were not designed with minorities in mind, and the continued scarcity of research in Latino populations has hindered the development of culturally-competent interventions that might reduce overweight prevalence. The challenges encountered while implementing Activa Y Sana, a population-specific intervention, are described in Study #3.The results from this research may be used to help inform the design of future intervention programs with the goal of reducing the burden of obesity in Mexican-American children, currently the fastest-growing segment of the U.S. population.