Each month, the OMA Pediatric Committee reviews a pediatric-focused obesity research update to help keep you up to date about the latest findings. This month’s addresses obesity prevention among Hispanic children and families.
Family-Based Obesity Prevention Interventions among Hispanic Children and Families: A Scoping Review
September 15th to October 15th is National Hispanic American Heritage Month dedicated to celebrating generations of Hispanic Americans and their contributions to our nation, society and culture. Hispanics and Latinos are the second largest racial or ethnic population in the United States (White 57.8%, Hispanic 18.7%, Black 12.4%, Asian 6%). The Hispanic and Latinx population experiences a disproportionate obesity burden amongst both children and adults. This scoping review of family-based obesity prevention interventions illuminates gaps in our knowledge by examining characteristics from 13 family-based studies. Read the full article.
Since Hispanic youth are disproportionately affected by obesity, they also experience higher rates of comorbidities like hypertension, dyslipidemia, and impaired glucose tolerance as well as psychosocial consequences like reduced quality of life and social isolation. Hispanic youth are also one of the fastest-growing populations. These factors make it imperative to address obesity disparities in Hispanic youth in order to improve healthy equity.
This scoping review followed methodology developed by Arskey and O’Malley and utilized the following questions 1) What are the intervention and sample characteristics of family-based obesity prevention programs among Hispanic/Latino children? 2) Do existing family-based strategies consider SDoH to meet the needs of Hispanic families? 3) To what extent do existing family-based strategies with Hispanic families involve collaboration among community stakeholders?
Only 13 studies met the criteria defined as empirical, peer-reviewed, published between 2010-2020 and described as a family-based obesity prevention intervention among Hispanic youth and families (defined as having 75% of the study population self-identifying as Hispanic/Latino) with a focus on one or more behaviors related to nutrition, physical activity, reducing sedentary behaviors/screen time or improving sleep. Families were defined as having at least one parent/guardian over 18 years of age and children 5-18 years of age.
Of note, four (31%) studies reported clinically significant improvements in BMI, four (31%) studies reported improvements in nutrition-related behaviors or knowledge and three (23%) studies reported improvements in physical activity.
Examples of social determinants of health (SDoH) addressed included culture, language and contextual factors. Studies employed various tools like adapted reading materials, workbooks and recipes delivered in Spanish; cultural media in the form of telenovelas; and specific methods of addressing stress from immigration, access to healthcare and barriers to behavior change. Examples of community collaborations included use of a community advisory board, engaging physicians and other stakeholders, as well as utilizing promotoras or lay community health educators who are members of the Spanish-speaking community.
The strengths of studies examined in this review included rigorous randomized control trial studies, moderate to high retention rates, inclusion of families from low socio-economic status backgrounds, high levels of community collaboration and use of culturally adapted materials in Spanish and English.
While almost all studies in this review utilized community collaborations, only half addressed SDoH, highlighting a failure to leverage those community collaborations to address SDoH and connect families to resources. Authors of this review stressed the importance of using promotoras as a model for implementation. Promotoras are an essential part of any family-based program due to their familiarity with the local Spanish-speaking community, and Hispanic culture, values and norms. Promotoras have demonstrated significant influence on obesity interventions in previous research through their caring, shared experiences, creation of trust in research and ability to motivate families to adapt long-term changes.
There is a need for a greater number of studies on family-based programs for Hispanic youth and families struggling with obesity. This review could be strengthened by the inclusion of more studies, as well as studies written in Spanish and taking place in other Spanish-speaking countries, as they may provide insight into unknown cultural components or strategies. Future studies should investigate the effects of acculturation and family dynamics on participation, test various theoretical methods, address SDoH more thoroughly and consistently, continue to utilize community collaborators like promotoras, as well as help to define family involvement and methods of evaluation. Without this information, we are not equipped to fully address the disparities seen in obesity and improve health equity for our Hispanic youth and families.
Find more resources, curated by OMA’s Pediatric Committee, on our Pediatric Resources page. There you’ll find additional article reviews on various topics related to obesity as well as public resources for clinicians and families.