Pragmatic Pilot Study of the Healthy Living Program: An Obesity Prevention and Treatment Program for Low-Income Hispanic Families Delivered Through Clinic–Community Partnership

Abstract

Background:

Few childhood obesity interventions have been designed for Hispanic families including Spanish speakers. This pragmatic pilot study assessed the effectiveness of a whole-family obesity prevention and treatment program—the Healthy Living Program (HeLP).

Methods:

HeLP is delivered at recreation centers by teams of health educators and fitness professionals. HeLP involves 12 group sessions, including parenting, child feeding, nutrition, cooking, meal planning/shopping, and fitness. Primary care providers referred families of children 2 years and older with obesity. This pragmatic longitudinal study collected data at the intervention and from electronic health records to compare child BMI trajectories from 12 months pre- to 12 months postintervention, in terms of the percentage of the 95th percentile BMI (BMI%95) using hierarchical mixed-effects models to account for clustering and to adjust for age, sex, weight status, and language.

Results:

Median attendance was 8 of 12 sessions. Of 317 children who had BMI measured clinically 1 year prior to HeLP, 265 (84%) had BMI measured 1 year post-HeLP, including 210 with overweight or obesity and 55 healthy weight siblings. About 71% of parents spoke Spanish only. Changes in modeled BMI%95 trajectory for children with overweight or obesity were: −6.7% [95% CI −13.0%, −0.4%] (p = 0.04) for 2–6 years, −5.8% [−8.6%, −3.0%] (p < 0.0001) for 7–11 years, and −4.1% [−6.8%, −1.4%] (p = 0.003) for 12–18 years. Children with overweight decreased −4.6% [−8.4%, −0.9%] (p = 0.001).

Conclusions:

These data suggest that HeLP, a whole-family intervention delivered by clinic–community partnership, may be effective at preventing and treating obesity in children from Hispanic families with low income and support an ongoing randomized controlled trial.