AN OBESITY INTERVENTION PROGRAM FOR HISPANIC ADOLESCENTS

Abstract

Purpose/Aims: The purpose of the study was to evaluate the feasibility, acceptability and preliminary efficacy of a theory-based healthy eating and activity intervention (Sabor con Salud Latino para los Niños [SSLN]). Relationships between self-efficacy, peer and parent social support and acculturation as key factors associated with eating and activity behaviors in Hispanic youth were explored. Background: Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile (Ogden et al., 2010). While personal, behavioral, and environmental factors contribute to these high rates, emerging literature suggests acculturation, self-efficacy and social support are key influences. Methods: The one-group, pre- and post-test, quasi-experimental design used a community-based participatory research (CBPR) method to test the feasibility, acceptability, and preliminary efficacy of the 8-week intervention. Social Cognitive Theory (SCT) was used to guide the intervention. Measurements included an analysis of recruitment, retention, participant satisfaction, observation of intervention sessions, paired t-tests, effect sizes, and bivariate correlations between study variables (acculturation, nutrition and physical activity [PA] knowledge, attitude and behaviors, perceived confidence and social support) and outcome variables (BMI z-score, waist circumference and BP percentile). Results: Findings showed the SSLN program was feasible and acceptable. Seventeen participants (10 females and 7 males) aged 11-14 years enrolled in the study. SSLN completers (n=16) attended 88.1% of the sessions. Retention strategies such as texting reminders for class, raffle prizes and phone calls to parents increased attendance and strengthened communication between parents, adolescents and the SSLN Instructors. Participants reported that the curriculum was fun (M = 4.63, SD = .72) and they learned about nutrition (M = 3.81, SD = 1.42) and PA (M = 4.25, SD = 1.13). The preliminary effects on adolescent nutrition and PA behaviors showed mixed results with small-to-medium effect sizes for nutrition knowledge and attitude, PA and sedentary behavior. Correlation analysis among acculturation and study variables was not significant. Positive associations were found between perceived confidence in eating and nutrition attitude (r = .61, p < .05) and nutrition behavior (r = .62, p < .05), perceived confidence in exercise and nutrition behavior (r = .66, p < .05), social support from family for exercise and PA behavior (r = .67, p < .01) and social support from friends for exercise and PA behavior (r = .56, p < .05). Implications: These findings suggest a culturally specific healthy eating and activity program for adolescents was feasible and acceptable and warrants further investigation, since it may fill a gap in existing obesity programs designed for Hispanic youth. The positive correlations suggest further development and testing of the theoretical model.