Active & Healthy Families
(Familias Activas Y Saludables)
A Pediatric Overweight Group Appointment Program For Latino Families
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What is Active & Healthy Families?
Active & Healthy Families (AHF) is a family-based group medical appointment program of Contra Costa Public Health Clinic Services located in Contra Costa County, California. The program is open to Latino children age 5-12 years with BMI of 85 percentile and above. A parent is required to attend each appointment with the child.
The AHF program is a model intended for Latino families with overweight/obese children served by Federally Qualified Health Centers (FQHCs). This program is currently offered in selected Contra Costa County federally qualified school-based clinics and has been replicated by FQHCs in two other counties in the San Francisco Bay Area.
Goal of the AHF Program
The AHF program is designed as a first level family education on obesity prevention. Knowledge of healthier food habits/lifestyle provides the child and family choices to work on for changes in their daily living. The AHF team guides and supports each participant and their families in their adoption and maintenance of healthier lifestyle changes. The principles of the Four Stages of Change model is the approach used in assisting participants succeed in making healthy lifestyle changes.
Program Content (8 Group Appointments and 6 Individual Monthly Appointments)
The AHF program consists of eight-2 hour appointments every other week followed by six individual monthly appointments with the AHF team.
|Group Appointments||Topics Covered|
|1. Why Getting to a Healthy Weight Matters||Benefits of a Healthy Weight|
|2. Sugar in Drinks and Cereal||Sugar Content of Popular Drinks and Cereals|
|3. Eating Smart||Reading a Nutrition Facts Label, My Plate, Adequate Portions|
|4. Stress, Physical Activity and Screen Time||Positive Coping Responses for Stress, Benefits of Physical Activity, Limiting Screen Time|
|5. Responsibilities of Parents and Children||Division of Responsibility in Feeding|
|6. Maintaining a Physically Active Lifestyle||Easy Physical Activity Routines|
|7. Maintaining Healthy Nutrition Habits||Changes in Diet to Prevent/Manage High Cholesterol and Triglycerides|
|8. Review and Graduation||Certificates of Completion|
Individual monthly appointments for six months for participants who completed the program (attendance of at least six or all of the eight group appointments required).
Important Features of the AHF Program
- Delivered by a Provider Triad (Physician/Nurse Practitioner, Registered Dietitian/Nutritionist, Community Health Worker)
- Culturally and linguistically tailored curriculum for Latino children and family
- Interactive activities for children and parents included at each appointment
- Individual time for child and parent with medical provider at each group appointment
Background of AHF Program
Response to High Prevalence of Obesity amongst Latinos
Latinos have the highest prevalence of obesity in Contra Costa County for youth age 2-19 years (PedNSS, 2010). Many Latinos face barriers maintaining good health, such as limited access to health insurance, cultural and linguistic factors, and socioeconomic and immigration status. In response to the need and barriers facing the Latinos, the AHF program is culturally as well as linguistically tailored for the Latino families.
First Prize Winner of the 2013 Childhood Obesity Challenge
The AHF program for Latinos was the first prize winner of the 3rd round obesity challenge sponsored by the American Journal of Preventive Medicine (AJPM)
Evaluation and Results of Randomized Controlled Study by University of California (Berkeley)
The AHF program for Latinos was evaluated by the University of California in Berkeley during the fall of 2012 and spring of 2013 in a randomized controlled study. The study was funded by Safeway Foundation. Changes from baseline to post-intervention (10 weeks) in BMI, fasting blood sugar and blood lipids were compared between the intervention and the wait-list groups. The study took place in two Contra Costa County FQHCs. The participants were 40 Latino children age 5 to 12 years with a body mass index (BMI) of 85 percentile and above and their parents.
Results - Among the first 23 participants enrolled, there was a significant weight loss for the intervention group versus the control group (-0.5 lbs vs +2.0 lbs, p=0.012) and significant change in BMI (-0.6 kg/m vs+0.1 kg/m , p=0.004). There was a trend for differences in change in triglycerides (-14.8 vs +4.8, p=0.12) as well. Attendance to the AHF appointments among the intervention group was high, ranging from 82% to 98%.
The study was published in June, 2015 in Academic Pediatrics and was presented at the 8th Biennial Childhood Obesity Conference in San Diego, California.
INTRODUCTION TO THE TRAINING SITE
To all future users of the AHF Training website for Latinos,
The training site intends to provide all the materials and curriculum of the AHF program for providers planning to replicate the AHF in their own clinic. The AHF team members’ script/talking points for each group appointment are also included in Spanish and English.
To ensure successful replication of the AHF group appointments program, it is strongly recommended to complete all the steps listed in the ACTIVITY CHECKLIST (below) before starting with the AHF Training website.
Please note that registration to create a Log In account is required for users of the AHF Training Site.
Annabelle Cadiz, MS, RD
Consultant, AHF Program
Daniela Jaramillo, RD
AHF Team Nutritionist
(Steps in the Replication of AHF Pediatric Overweight Group Appointment Program)
|STEPS||Responsible Party||Date Completed|
|1||Understand the program's goal||All team members|
|2||Get administration's support||MD/NP|
Establish the AHF Triad:
(FQHC) fees for service; funding for materials, snacks in each appointment
|5||Recruitment of at least 25 participants,
5-12 years with BMI>85%. Goal is 10-12 attendees at each appointment.
|6||Establish physician referral system for AHF eligible participants at least 3 months prior to start of program.||AHF Team|
|7||Identify a meeting place for the group appointments (location can accommodate up to 30 people which includes children and parents)||Administration|
|8||Preparation of the following: at least a month before start of program:
handouts, posters, forms, incentives and materials needed at each group appointment
|9||Designate a third party- program Evaluator||CHDP Nutritionist/Health Plan representative|
Daniela Jaramillo, RD
AHF Team Nutritionist
Contra Costa County Public Health