Session: Family-Based Programs for Childhood Obesity Prevention: Engagement, Characteristics, and Intervention Effects (Society for Prevention Research 27th Annual Meeting)

Childhood obesity is at epidemic levels in the US. Having an elevated BMI (≥85^th%ile for age and gender) during childhood increases the risk for obesity in adulthood and its physical (cardiovascular disease, diabetes, high blood pressure, dyslipidemia, cancers) and psychological/psychosocial (self-esteem, depression, school failure) correlates. The US Preventive Services Task Force identified family-based interventions as best practice for children age 6 to 17 with elevated BMI. Intervention targets center on parenting, nutrition/eating behaviors, physical/sedentary behaviors, and sleep. Recently, evidence emerged supporting the adaptation of existing parenting programs to more effectively target obesogenic behaviors. This symposium focuses on two trials of these adapted programs for the prevention of excess weight gain. These programs are the Family Check-Up 4 Health (FCU4Health) and the Familias Unidas for Health and Wellness (FUHW). The first paper examines engagement of underserved families in a randomized trial of the FCU4Health, compared to services as usual, through in-person and recruitment calls in pediatric primary care clinics. Results indicate high rates of enrollment among families screening eligible (93%) and an engagement rate in the FCU4Health of 70% indicating acceptability and the potential for scale up of this program in primary care. The second paper presents the results of a latent profile analysis from the same trial in which three distinct profiles were identified based on child BMI, parenting, child and family health behaviors, and family health routines. These ecological influences largely aligned with the child BMI with the highest BMI group having the lower levels of parent limit setting; loose household structure related to media, mealtime, and sleep routines; and had poorer diet, eating behaviors, and physical activity levels compared to the other two classes. These findings indicate the need to tailor interventions to the unique needs of these families. The third paper presents the findings of an efficacy trial of 280 Hispanic youth with elevated BMI randomized to FUHW or to community practice. Results indicate that, relative to control, adolescents randomized to FUHW reported increases in family functioning from baseline to post intervention, specifically on indicators of family communication and parental involvement, and parents experienced reductions in BMI. The findings demonstrate that FUHW has promising short-term effects on family functioning and parent’s BMI. Long-term follow-up is the next step. Together these studies indicate that prevention of youth obesity and excess weight gain is challenging and best approached through the family. Tailoring for unique profiles could improve outcomes.