Abstract
iCook 4-H is a lifestyle intervention to improve diet, physical activity and mealtime behavior. Control and treatment dyads (adult primary meal preparer and a 9–10-year-old youth) completed surveys at baseline and 4, 12, and 24 months. A Health Disparity (HD) score composite was developed utilizing a series of 12 questions (maximum score = 12 with a higher score indicating a more severe health disparity). Questions came from the USDA short form U.S. Household Food Security Survey (5), participation in food assistance programs (1), food behavior (2), level of adult education completed (1), marital status (1), and race (1 adult and 1 child). There were 228 dyads (control n = 77; treatment n = 151) enrolled in the iCook 4-H study. Baseline HD scores were 3.00 ± 2.56 among control dyads and 2.97 ± 2.91 among treatment dyads, p = 0.6632. There was a significant decline in the HD score of the treatment group from baseline to 12 months (p = 0.0047) and baseline to 24 months (p = 0.0354). A treatment by 12-month time interaction was found (baseline mean 2.97 ± 2.91 vs. 12-month mean 1.78 ± 2.31; p = 0.0406). This study shows that behavioral change interventions for youth and adults can help improve factors that impact health equity; although, further research is needed to validate this HD score as a measure of health disparities across time.
Highlights
While there are many variations in how “Health Disparities” is defined [1,2,3], Braveman et al (2014)defined health disparities as “worse health among socially disadvantaged individuals, those of disadvantaged racial/ethnic groups” [4,5]
For the subproject described in this article, researchers sought to determine whether participation in a childhood obesity prevention intervention, iCook 4-H, could reduce participant’s health disparity burden by using a Health Disparity (HD) Score
There were 228 dyads that consented and enrolled into the iCook 4-H program from all five states with 195 that continued after the first session, with mean age of youth (9.35 ± 0.67 years) and adults
Summary
Defined health disparities as “worse health among socially disadvantaged individuals, those of disadvantaged racial/ethnic groups” [4,5]. A clear classification system to identify individuals with health disparities has not yet been established, the idea that health disparities need to be eliminated, or at least mitigated, is widely accepted both nationally and internationally [6]. Health disparities adversely affect groups of people who have systematically experienced greater social and/or economic obstacles to being healthy, based on their racial or ethnic group, religion, Healthcare 2018, 6, 51; doi:10.3390/healthcare6020051 www.mdpi.com/journal/healthcare. In Healthy People 2020, reducing health disparities was a primary objective with goals to “achieve health equity, eliminate disparities and improve the health of all groups”. The Centers for Population Health and Health Disparities (CPHHD) Program, through the National Institutes of Health (NIH), has called for a new direction in health disparity research, with renewed focus on addressing disparities at the individual and community levels, by utilizing interventions that improve health behavior choices [8]
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