Utilizing children as change agents to promote healthy family lifestyle behaviors

Objective: To assess the impact of a healthy choices and activities intervention program utilizing goal coaches to guide adolescents as positive change agents for Latino parental/caregiver family food decisions Study Design, Setting, and Participants: Research design included two phases: (1) a developmental phase with youth and goal-coach curriculum development and testing, and (2) an implementation phase with a 6-week healthy choices and physical activities intervention pilot program. Participants in the developmental and pilot phase of the study include both children (10-14 years) and their Spanish speaking primary caretakers who attend a church youth group program in central North Carolina. Goal coaches include youth mentors between the ages of 18 to 24, recruited from a local college in central North Carolina. Outcome, Measures and Analysis: 1) Content analysis of focus groups with youth and goal coaches were conducted to determine ease of use and compliance with study methodology, including photo journaling and family goal setting, as well as message appropriateness for youth and goal coaches. 2) During implementation and one month follow up the following were assessed: pre/post testing of parent/caregiver food behaviors, fruit and vegetable intake, and physical activity behaviors; youth nutrition, physical activity habits and BMI; and adherence to established family goals. Results: 21 youth and 5 goal coaches were recruited to participate. All materials were developed utilizing constructs from the Social Cognitive Theory, and translated. 1) During the focus groups, goal coaches reported that they learned from the youth that parents are a barrier to influencing healthy family behaviors. Youth also reported that they were non-compliant with the use of the photo journal. 2) Youth were able to successfully set family-based nutrition and physical activity goals with 82% family compliance overall. Parents reported increased physical activity and healthy food behaviors pre- and post-intervention, including increased nutrient-dense food purchasing one-month post-intervention. One-month follow-up surveys reported an increase in healthy nutrition and physical activities in homes. Conclusions and Implications: This innovative approach is a promising strategy for reducing the adverse health effects associated with dietary acculturation among Latino families. It builds upon the inherent value of familism as well as the strengths of adolescents as carriers of nutrition and health information. Future research is needed to expand upon these strategies to better tailor nutrition education messaging for Latino immigrant families