Abstract

With pediatric obesity rates reaching epidemic scales across the United States, innovative research to identify key factors for successful implementation of obesity intervention programs is increasingly paramount. Project Healthy Attitudes Produces Positive Youth (HAPPY) is a family centered pediatric obesity prevention program targeting elementary age children and their families. To determine whether Project HAPPY interventions emphasizing social networks were successful. This was a small scale evaluation of the Project HAPPY pilot program, conducted after school at a public elementary campus in Solano County, California. From April 2018 to May 2018, first year medical students from Touro University California College of Osteopathic Medicine served as "family navigators," guiding participants through a 5 week curriculum of didactic lessons, cooking demonstrations, and physical exercises. Eligibility requirements for Project HAPPY included basic English proficiency, confirmed enrollment of at least one child at the elementary school, and willingness to attend all study sessions. Theprimary outcome evaluated was a shift in attitude toward individual health. Changes in body mass index (BMI) and health behaviors were assessed as secondary outcomes. Outcomes were assessed through surveys and measurements of BMI completed during Session 1, Session 10, and 4, 6, and 8 month follow up sessions. Initial study participants included seven families, consisting of elementary school students with their siblings and parents (n=27). Only four families (n=13) completed the entire 5 week intervention. Over the course of the study, survey results of participants' attitudes regarding health suggested a positive trend toward self efficacy, while BMI appeared stable or increased. Participants demonstrated retention of successful health behaviors up to 8 months after the end of the intervention through qualitative reports of being "more conscious of meals and what (they) are eating," "valu[ing their] nutrition on a daily basis," "play[ing] a lot outside and inside on the weekends," "carry[ing] a water bottle," and "cook(ing) a lot." A higher percentage of respondents in the final session compared selected the option "strongly agree" to each of the following statements: "I can be healthier if my family works together" (87.5% final session vs. 84.6% first session), "Drinking water makes me healthy" (87.5% final session vs. 84.6% first session), "Moving my body makes me healthy" (87.5% final session vs. 76.9% first session), "I reach my goals even when things get in my way" (62.5% final session vs. 46.2% first session), "Eating fruits and veggies make me healthy" (100% final session vs. 92.3% first session), "I can be healthy and enjoy my favorite foods" (87.5% final session vs. 66.7% first session), and "I can create a healthy balanced meal" (87.0% final session vs. 75.0% first session). Concrete data analysis was severely complicated by loss of study participants to follow up and incomplete data collection. Project HAPPY showed promising indications that should be further evaluated in studies of larger scale and longer duration.

Highlights

  • Context: With pediatric obesity rates reaching epidemic scales across the United States, innovative research to identify key factors for successful implementation of obesity intervention programs is increasingly paramount

  • Current research suggests that pediatric obesity prevention programs can be successful when targeted at younger children (

  • Project Healthy Attitudes Produces Positive Youth (HAPPY) was conducted at an elementary school in Solano County, California

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Summary

Introduction

Context: With pediatric obesity rates reaching epidemic scales across the United States, innovative research to identify key factors for successful implementation of obesity intervention programs is increasingly paramount. Project Healthy Attitudes Produces Positive Youth (HAPPY) is a family centered pediatric obesity prevention program targeting elementary age children and their families. Dedicated interventionalists have the time and energy to apply specialized training in nutrition toward individualized interventions for specific participant groups and refined presentation strategies, whereas classroom teachers prioritize lesson plans and lectures, with the majority of their time taken up by attending to essential classroom logistics [16] Based on this pool of evidence, we designed Project Healthy Attitudes Produce Positive Youth (HAPPY) as a pediatric obesity intervention program that utilized a family based approach and incorporated the unique factor of a trained medical student “family navigator.”. Navigators were medical students who received interventionalist training for 12 weeks through biweekly lunchtime sessions on nutrition, exercise, diet, socioeconomic barriers to healthy lifestyle changes, and social determinants of pediatric obesity. The family navigator’s role was to foster a collaborative environment for dialogue, educate the family on healthy habits, and encourage the family toward healthier choices

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