Hispanic youth have the highest risk for obesity, making this population a key priority for early childhood interventions to prevent the development of adult obesity and its consequences. Involving parents in these interventions is essential to support positive long-term physical activity and nutrition habits. Interventions in the past have engaged parents by providing information about nutrition and fruit and vegetable intake through written materials or text such as newsletters and text messages. The Sustainability via Active Garden Education (SAGE) intervention used gardening and interactive activities to teach preschool children ages 3-5 about healthy eating and physical activity. It aimed to increase physical activity and fruit and vegetable intake in preschool children as well as improve related parenting practices. The intervention utilized newsletters to engage parents by promoting opportunities to increase physical activity and fruit and vegetable intake for their children at home. The newsletters also encouraged parents to discuss what was learned during the SAGE lessons with their children. The purpose of this paper is to describe the content of the newsletters and determine the parent perception of the newsletters through parent survey responses. This can help inform future childhood obesity interventions and parent engagement.
Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes.
Methods
Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance.
Discussion
The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth.