title: The Healthy Children, Strong Families intervention promotes improvements in nutrition, activity and body weight in American Indian families with young children.
abstract: American Indian children of pre-school age have disproportionally high obesity rates and consequent risk for related diseases. Healthy Children, Strong Families was a family-based randomized trial assessing the efficacy of an obesity prevention toolkit delivered by a mentor v. mailed delivery that was designed and administered using community-based participatory research approaches.
  
  
  
  During Year 1, twelve healthy behaviour toolkit lessons were delivered by either a community-based home mentor or monthly mailings. Primary outcomes were child BMI percentile, child BMI Z-score and adult BMI. Secondary outcomes included fruit/vegetable consumption, sugar consumption, television watching, physical activity, adult health-related self-efficacy and perceived health status. During a maintenance year, home-mentored families had access to monthly support groups and all families received monthly newsletters.
  
  
  
  Family homes in four tribal communities, Wisconsin, USA.
  
  
  
  Adult and child (2-5-year-olds) dyads (n 150).
  
  
  
  No significant effect of the mentored v. mailed intervention delivery was found; however, significant improvements were noted in both groups exposed to the toolkit. Obese child participants showed a reduction in BMI percentile at Year 1 that continued through Year 2 (P<0·05); no change in adult BMI was observed. Child fruit/vegetable consumption increased (P=0·006) and mean television watching decreased for children (P=0·05) and adults (P=0·002). Reported adult self-efficacy for health-related behaviour changes (P=0·006) and quality of life increased (P=0·02).
  
  
  
  Although no effect of delivery method was demonstrated, toolkit exposure positively affected adult and child health. The intervention was well received by community partners; a more comprehensive intervention is currently underway based on these findings.
authors.affiliation: 1Department of Nutritional Sciences,University of Wisconsin,College of Agricultural & Life Sciences,Madison,WI,USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Tomayko
authors.affiliation: 2Department of Family Medicine,University of Wisconsin School of Medicine and Public Health,1100 Delaplaine Court,Madison,WI 53715,USA.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Prince
authors.affiliation: 2Department of Family Medicine,University of Wisconsin School of Medicine and Public Health,1100 Delaplaine Court,Madison,WI 53715,USA.
authors.forename: Kate A
authors.initials: KA
authors.lastname: Cronin
authors.affiliation: 2Department of Family Medicine,University of Wisconsin School of Medicine and Public Health,1100 Delaplaine Court,Madison,WI 53715,USA.
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Adams
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D004032:Diet; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007198:Indians, North American; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D011788:Quality of Life; D013690:Television; D014922:Wisconsin
keywords: American Indian; Community-based participatory research; Early childhood; Family; Home-based intervention; Nutrition; Paediatric obesity; Physical activity