University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
Colorado School of Public Health, Aurora, CO, USA.
Health Promot Pract. 2022 May;23(3):518-529. doi: 10.1177/1524839921993054. Epub 2021 Mar 5.
The U.S. Preventive Services Task Force recommends referral of all obese children to intensive weight management programs. When available, programs are limited to clinical settings and do not address social determinants of health barriers to healthy weight among Latinx immigrant families. Active and Healthy Families, a Spanish-language, culturally tailored group visit intervention has demonstrated effectiveness in decreasing child body mass index but does not address barriers to frequent engagement with the health care system nor social determinants other than immigration. Adapting the intervention for community-based delivery, and to address additional social determinants, may facilitate participation and increase acceptability and engagement among Latinx immigrant families.
To engage a stakeholder network in planning adaptations of an evidence-based weight management intervention for community-based implementation.
Guided by the intervention mapping-adapt process, we solicited feedback from a stakeholder network from August 2018 to March 2020. The stakeholder network assessed fit, planned adaptations and identified essential intervention components using photovoice, a Participatory Action Research method, and meetings incorporating user-centered design approaches.
The stakeholder network membership included Latinx immigrant families, community leaders, health care delivery experts, and researchers. Planned adaptations included curriculum changes to discuss social determinants barriers to behavior change and goal setting to mitigate them.
We successfully engaged a stakeholder network and, using a systematic process, identified adaptations of an evidence-based weight management intervention to allow for community-based implementation. Sustainably addressing obesity disparities for Latinx children also requires addressing structural factors to reduce social determinants of health barriers at the population level.
美国预防服务工作组建议将所有肥胖儿童转介到强化体重管理计划中。当可用时，这些计划仅限于临床环境，无法解决拉丁裔移民家庭健康体重的健康决定因素障碍。“积极健康家庭”是一种西班牙语、文化上量身定制的小组访问干预措施，已证明在降低儿童体重指数方面有效，但并未解决与频繁参与医疗保健系统相关的障碍，也未解决除移民以外的其他健康决定因素障碍。调整干预措施以进行社区交付，并解决其他社会决定因素，可能有助于拉丁裔移民家庭参与，并提高其可接受性和参与度。
让利益相关者网络参与规划基于证据的体重管理干预措施，以进行社区实施。
我们在干预映射适应过程的指导下，从 2018 年 8 月到 2020 年 3 月，向利益相关者网络征求反馈意见。利益相关者网络使用照片声音（一种参与式行动研究方法）和包含以用户为中心的设计方法的会议，评估适应性、计划适应性并确定基本干预组件。
利益相关者网络成员包括拉丁裔移民家庭、社区领袖、医疗保健服务专家和研究人员。计划的调整包括课程变更，以讨论行为改变和目标设定的社会决定因素障碍，并减轻这些障碍。
我们成功地让利益相关者网络参与进来，并使用系统的过程确定了对基于证据的体重管理干预措施的调整，以允许进行社区实施。要可持续地解决拉丁裔儿童的肥胖差异，还需要解决结构性因素，以减少人口层面的健康决定因素障碍。
