From Clinic to Community: Adapting Evidenced-Based Weight Management for Overweight Latino Children in Immigrant Families

Join us as this presenter discusses this poster live on Tuesday, August 11, 2020 | Track D at 5:05 PM Mountain

PRESENTER
LISA ROSS DECAMP
Associate Professor, University of Colorado School of Medicine/Children’s Hospital Colorado
BACKGROUND
US born Latino children with immigrant parents, who comprise half of Latino children, have a higher rate of childhood obesity than other Latino children. The US Preventive Services Task Force recommends referral of all obese children to intensive weight management programs to decrease body mass index. When available, intensive programs are limited to clinical settings and do not address social determinants of health among Latino immigrant families. Active and Healthy Families (AHF), a Spanish-language, culturally tailored group visit program for children has demonstrated effectiveness in decreasing body mass index.1 AHF does not address families’ barriers to frequent engagement with the healthcare system nor social determinants barriers other than immigration. Adapting the intervention for community-based delivery may increase acceptability and family engagement.
PURPOSE
To engage a stakeholder network in identifying adaptations of an evidence-based weight management intervention for community-based implementation.
METHODS
Guided by the intervention mapping-adapt process, we solicited feedback from a stakeholder network from Aug 2018-Dec 2019.2 The network included 4 subcommittees: 1) Latino immigrant families including those who had participated in AHF delivered in a healthcare setting; 2) members of and leaders of community organizations; 3) healthcare services delivery leaders; and 4) researchers in health disparities and Latino health. Subcommittee activities included applying user-centered design principles and Photovoice, a participatory action research method.
RESULTS
Stakeholders identified three functions3 (i.e. essential components) of the evidence-based intervention: a collaborative, multidisciplinary facilitation model, use of the transtheoretical model of change to prompt family-level behavior change tailored to cultural values, and a financially sustainable reimbursement model. The network reached consensus on forms (strategies to meet each function) needed for community-based implementation. Form changes included: 1) different professional roles of facilitators to better align with availability of community experts, family preferences, and to contain costs; 2) incorporation of social determinants facilitators and barriers to behavior change and strategies to mitigate these barriers into the curriculum; and 3) addressing financial sustainability using the Medicare Diabetes Prevention Program as a model. (See Table 1)
CONCLUSIONS
Stakeholder engagement as part of an intervention mapping process defined functions of an evidence-based weight management intervention and key form changes for community-based vs. clinic-based implementation. Community-based implementation may better address some social determinants of health barriers to healthy weight for Latino children in immigrant families.
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