THE FAMILY HEALTH PROJECT
OVERVIEW
The Family Health Project was a family-based intervention designed to improve cardiovascular health among Mexican-American and Anglo-American parents and children. In a random assignment study, families at schools assigned to implement the Family Health Project were compared with families at schools assigned to implement no intervention. Results over a four-year follow-up period were inconsistent; however, some evidence does suggest that the Family Health Project led to improved dietary behavior. For both the Mexican-American and Anglo-Americans in the treatment group.
DESCRIPTION OF PROGRAM
Target population: Mexican-American and Anglo-American families
The Family Health Project was a family-based intervention designed to improve cardiovascular health. The intervention, based on social learning theory and principles of self-management, was designed to assist families in making long-term changes to their physical activity and dietary habits. The intervention sought to reduce participants' daily sodium intake to 3 grams, to reduce participants' fat intake to 30% of total calories consumed, and to increase participants' regular physical activity.
The one-year program included 12 weeks of intensive intervention, followed by six maintenance sessions distributed over a nine-month period. During the intensive intervention period, families attended weekly 90-minute meetings that taught self-monitoring, goal-setting, problem-solving, self-rewarding goal achievement, and support-providing.
Meetings always began with an aerobic exercise activity. Following this activity, parents and children separated in order to receive new information and skills. Active participation was stressed, and children frequently learned new information and skills through game-play. Families then reconvened to set short-term goals for diet, exercise, and family support. At the end of each session, families ate heart-healthy snacks together. A different family prepared the snacks each week.
Maintenance sessions covered topics such as breaking bad habits, making healthy choices in restaurants, grocery shopping, friend and peer pressure, and planned and unplanned breaks in exercise and dietary routines.
The program was designed to be delivered to ethnically homogeneous groups of families. Groups were structured so as to maximize cultural, group, and family support for behavioral change and experiential learning.
EVALUATION(S) OF PROGRAM
Nader, P. R., Sallis,
J. F., Abramson,
Evaluated population: 206 families served as the study sample for this investigation. ("Family" was defined as any group of one or more children and one or more adults who cohabit and share family functions such as food preparation and socialization of children.) Families included students from the 5th and 6th grade classes at 12 elementary schools. At some schools, only Mexican-American families were selected to participate and, at other schools, only Anglo-American families were selected to participate.
Approach: Schools were randomly assigned to the treatment group or the control group. Schools assigned to the treatment group implemented the Family Health Project intervention. Intervention sessions were conducted by trained, supervised facilitators. At intervention schools from which only Mexican-American families had been recruited, the Family Health Project intervention was conducted in Spanish and was culturally adapted to better suit a Mexican-American audience.
All families completed baseline assessments before the intervention period began. Follow-up assessments took place 3, 12, 24, 36, and 48 months after baseline assessments. Assessments included diet and exercise recalls, as well as measurements of blood pressure levels, serum lipid levels, body mass index (BMI). Additionally, at the six-month follow-up, families' behavior was observed during a day at the zoo.
Results: Results over the four-year follow-up period were inconsistent; however, the researchers identified changes in blood pressure and reported dietary behavior as "the most convincing evidence of consistent intervention effects." These results were more pronounced for adults than for children.
Treatment children, with the exception of Mexican-American boys, had significantly more healthy diets than did control group children at the three-month follow-up. This impact was no longer significant at the 24-month follow-up. Anglo women and Mexican-American girls from the treatment group had more healthy diets than did their control group counterparts at the 48-month follow-up. The only significant blood pressure differences between treatment and control children were for Anglo boys at 24 months and for Anglo girls at 48 months.
Differences in nutritional intake were found within some subgroups at some timepoints. Mexican-American treatment boys had significantly lower total fat consumption than did Mexican-American control boys at the 48-month follow-up. Anglo treatment children had significantly lower dietary fat consumption than did Anglo control children at the three-month follow-up. This impact remained significant for girls at the 24- and 48-month follow-ups, but ceased to be significant for boys. Anglo treatment children also had significantly lower sodium consumption than did Anglo control children at the three-month follow-up. This impact was still significant for boys at the 24-month follow-up and was still significant for girls at the 48-month follow-up.
In general, treatment children did not differ from control children on energy expenditure and physical activity. At the 48-month follow-up, however, Anglo treatment boys did report having engaged in significantly more physical activity than did Anglo control boys. Anglo treatment girls had greater cardiovascular fitness than did Anglo control girls at the three-month follow-up. Mexican-American treatment girls had greater cardiovascular fitness than did Mexican-American control girls at the 24-month and 36-month follow-ups.
At no time point did treatment group members differ from control group members on measures of body mass index (BMI).
During the observed zoo visit, Mexican-American treatment families walked significantly further and spent significantly more time being active, as compared with Mexican-American control families. No differences in activity level were found between treatment and control Anglo families. All treatment families were less likely to use escalators (and more likely to walk up hills) than were control families. Treatment families also brought healthier snacks and consumed fewer calories than did control families while at the zoo.
Note: Analyses were designed to adjust for the effect of clustering within schools.
SOURCES FOR MORE INFORMATION
Contact curriculum developer Philip R. Nader for curriculum information:
References:
Nader, P. R., Sallis,
J. F., Abramson,
Program categorized in this guide according to the following:
Evaluated participant grades: 5th-6th
Program age ranges in the guide: Middle Childhood, Adolescence
Program components: Parent/Family Component
Measured outcomes: Physical Health
KEYWORDS: Physical Health, Cardiovascular Health, Hispanic or Latino, White or Caucasian , Nutrition, Family-Based, Life Skills Training, 5th grade, 6th Grade, Elementary School, Dietary Behavior, Physical Activity, Middle Childhood (6-11), Adolescence(12-17), Adolescents.
Program information last updated on 10/12/07.
|
|
|
© Child Trends 2003 |
|
|
|
