AN EMPIRICAL STUDY OF COMMUNITY AND FAMILY INTERVENTIONS TO PROMOTE PHYSICAL ACTIVITY AMONG LATINO YOUTH

Abstract

Physical inactivity contributes to risks for chronic disease and premature death (World Health Organization, 2010). Community coalitions play an important role in addressing and preventing chronic diseases (Butterfoss, Goodman, & Wandersman, 1993). This dissertation examines two intervention efforts related to the Latino Health for All Coalition's action plan, using an ecological perspective (McLeroy, Bibeau, Steckler, & Glanz, 1988). The first study involved a universal intervention to promote physical activity among Latino boys and girls (age 5-15) in Kansas City by offering structured soccer sessions consisting of soccer drills and informal games. These structured soccer sessions were promoted though an informal, flyer-based campaign. An empirical case study design and related measures were used to answer four questions: 1) How effective was the campaign in attracting overweight and obese Latino youth? (involved analysis of a paper-and-pencil survey by parents of participating youth), 2) How frequently did participants attend? (involved analysis of weekly attendance records), 3) How much moderate-to-vigorous physical activity did participants accumulate during these informal soccer sessions? (involved the use of Actigraph accelerometers), and 4) How satisfied were parents and youth with these physical activity opportunities? (involved analysis of a paper-and-pencil survey at the concluding session). Results show that 74 youth attended at least one of the weekly soccer sessions (90.5% Hispanic/Latino, 43.2% overweight or obese). On average, youth attended 4.2 sessions; there was no difference in attendance rate by gender (t(40)=2.08, p=0.48) or body mass index category [F(2, 49) = 0.16, p = 0.85]. A convenience sample of 12 participants accumulated 18.8 to 22.2 minutes of moderate-to-vigorous physical activity during a single soccer session. Both children and parents expressed high levels of satisfaction with the structured soccer sessions. In conclusion, these structured soccer sessions enabled a diverse group of Latino children and youth to accumulate about a third of their daily requirement of physical activity, in an enjoyable way. The second study examined a targeted family-based intervention to promote physical activity in home settings. It involved Latino children (3 boys, 2 girls), ages 5 to 7. The intervention occurred during the summer (June - August). Parents were taught to set weekly physical activity goals for their children, develop weekly behavioral contracts, and reinforce short bouts of physical activity. Children wore Actigraph accelerometers during waking hours to monitor changes in physical activity levels. The U.S. Department of Health and Human Services guidelines for physical activity were reviewed with parents, followed by weekly accelerometer feedback on their child's physical activity level. A multiple baseline design was used to examine the effects of the intervention on daily levels of moderate-to-vigorous physical activity. The intervention resulted in large changes in physical activity for one participant and minimal increases in daily levels of moderate-to-vigorous physical activity for three of the remaining four participants. Factors that explain the variance in initial increase in physical activity (e.g., the home and neighborhood environment) were explored. Parents were able to implement most intervention components well, with the exception of their ability to consistently reinforce 10-minute bouts of physical activity. Finally parents expressed high levels of satisfaction with the intervention. Targeted interventions that train parents to set goals and develop behavioral contracts show promise for increasing the physical activity levels of children. Future research is needed to determine the longer-term effects of such interventions. Finally, this dissertation study provides an initial assessment of the Latino Health for All Coalition using preliminary measures of process outcomes (e.g., partners engaged, interventions developed). The coalition's effects were explored across all ecological levels--individual, family, organizational, community--posed by McLeroy et al. (1988). Health-based community coalitions can play an important role in assuring the prevention of chronic diseases for all groups within the community.