Childhood Obesity Prevention Intervention: Leveraging Chinese-American Parents’ Activation and Locus of Control

Abstract

Purpose

To estimate the effect of the culturally-adapted Greenlight intervention on parent activation and locus of control (LOC) among Chinese-American immigrant parents.

Design

Prospective, quasi-experimental study.

Setting

A New York City-based federally-qualified health center with a large patient population of low-income, ethnically Chinese immigrant individuals and families.

Sample

444 Immigrant Chinese-American parents of infants (267 cross-sectionally enrolled historical controls and 177 Greenlight recipients followed prospectively).

Intervention

A culturally-adapted version of Greenlight, a health literacy- and communication-informed early childhood obesity prevention intervention in primary care which promotes certain healthy infant feeding practices at 12 months in the present sample.

Measures

Parent activation and LOC were measured at 6, 12, 24, and 36 month well child visits.

Analysis

Generalized estimating equations were used to examine the effects of the Greenlight intervention on the outcome measures.

Results

Compared to historical controls, parents receiving Greenlight were more likely to strongly agree with the activation statements: “I know how to prevent my child from becoming overweight” (adjusted odds ratio (aOR): 9.62 [4.70, 19.73]); “I have been able to help my child maintain recommended changes like eating right or exercising” (aOR: 6.42 [4.14, 9.97]); and “I am confident I can keep my child eating and exercising right, even when I am busy or stressed” (aOR: 8.44 [5.35, 13.31]). Greenlight recipients also demonstrated increased internal LOC (aOR: 2.02 [1.35, 3.03]) and decreased powerful others external LOC (aOR: 1.76 [1.23, 2.51]).

Conclusion

To reduce disparities in child obesity, especially among immigrant families, interventions must also prioritize parent factors like parent activation and LOC to build upon their inherent assets and promote long-term change.