title: Turn off the TV and dance! Participation in culturally tailored health interventions: implications for obesity prevention among Mexican American girls.
abstract: Our evaluation study identifies facilitators and barriers to participation among families participating in the treatment arm of Stanford ECHALE. This culturally tailored obesity prevention trial consisted of a combined intervention with two main treatment components: 1) a folkloric dance program; and 2) a screen time reduction curriculum designed for 7-11 year old Latinas and their families. We conducted 83 interviews (40 parents and 43 girls) in participant homes after 6 months of enrollment in the ECHALE trial. The Spradley ethnographic method and NVivo 8.0 were used to code and analyze narrative data. Three domains emerged for understanding participation: 1) family cohesiveness; 2) perceived gains; and 3) culturally relevant program structure. Two domains emerged for non-participation: program requirements and perceived discomforts. Non-parametric, Spearman's rank correlation coefficients were calculated to assess the relationships with participant attendance data. Sustained participation was most strongly influenced by the domain perceived gains when parents reported better self-esteem, confidence, improved attitude, improved grades, etc. (Spearman r = .45, P = .003). Alternatively, under the domain, perceived discomforts, with subthemes such as child bullying, participation in the combined intervention was inversely associated with attendance (Spearman r = -.38, P = .02). Family-centered, school-based, community obesity prevention programs that focus on tangible short-term gains for girls may generate greater participation rates, enhance social capital, and promote community empowerment. These factors can be emphasized in future obesity prevention program design and implementation.
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA. Dr.KathrynAzevedo@gmail.com
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Azevedo
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Mendoza
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA.
authors.forename: María
authors.initials: M
authors.lastname: Fernández
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA.
authors.forename: K Farish
authors.initials: KF
authors.lastname: Haydel
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Fujimoto
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA.
authors.forename: Evelyn C
authors.initials: EC
authors.lastname: Tirumalai
authors.affiliation: Solutions Science Lab, Division of General Pediatrics & Stanford Prevention Research Center, Stanford University, Medical School Office Building, 1265 Welch Road, X129, Stanford, CA 94305-5415, USA.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Robinson
mesh_terms: D002648:Child; D003615:Dancing; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D017058:Mexican Americans; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D013690:Television