Date of Award

2011-07-01

Degree Name

PhD Nursing

Dissertation Committee

Ann M. Mayo, RN, DNSc, FAAN, Chairperson; Kathy Shadle James, RN, DNSc, FNP, Committee Member; Sheila Gahagan, MD, MPH, Committee Member; Philip R. Nader, MD, Committee Member

Keywords

child outcomes, children & youth, health behaviors, Hispanics, low-income, maternal outcomes, nursing, Obesity intervention program, parents & parenting

Abstract

Background: One of the highest risk groups for childhood obesity and associated co-morbidities in the United States are low-income Hispanic preschool children. To reduce obesity, effective interventions are being sought to improve health behaviors among high risks groups. Objectives: To evaluate a subset of data from a larger 9-month promotora facilitated obesity intervention study. The aims were to determine: 1) pre- to post-program differences in health behaviors including: (a) children's consumption of high carbohydrate beverages (HCB); and (b) maternal walking, beliefs, knowledge, self-efficacy, and relationship building regarding nutrition and physical activity; and 2) which covariates were significant for change in outcome variables. Methods: A retrospective data analysis, pre post single group design was used to analyze a subset of data from the larger study consisting of a case sample of 33 low-income, Hispanic mothers (18- to 35-year-olds) with pre-school children (3- to 5-year-olds). Differences in outcome variables for related samples between baseline and 9 months were examined using: descriptive statistics, a matched-pairs t-test, the Wilcoxon signed-ranks test, and the chi-square test. Pearson and Spearman correlations were performed to assess relationships between covariates and outcome variables, and if regression analysis assumptions were met. A backward step-wise linear regression was run to determine covariates significant for change in health behaviors. Results: From baseline to 9 months, there was a 56% decrease in children's overall HCB consumption (soda, 100% juice, and sugary drinks); a 47% increase in water consumption; and a 58% increase in total maternal steps (Tuesday and Saturday). By 9 months, maternal beliefs were more positive about walking, knowledge increased about healthy drinks, and maternal self-efficacy improved regarding role modeling healthy behaviors. Gravida was correlated with increased Saturday steps and increased water consumption; and promotora visits were correlated with increased consumption of soda. Implications: Findings suggest a 9-month childhood obesity intervention program was effective in improving the target health behaviors for a low-income Mexican American community and identifying effective means for reducing the incidence of obesity in high risks groups. A larger randomized control trial is needed to further test the feasibility of this intervention program.

Document Type

Dissertation: Open Access

Department

Nursing

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