Promoting Healthy Family Behaviors in Pediatric Primary Care: Little Steps 4 Health, a Community CQI Project
Abstract
Introduction:
More than 14.4 million children in the United States are affected by obesity. This problem partially arises from the gap in care between follow-up appointments between families and providers, as parents are unaware of how to start lifestyle changes. LittleSteps4Health (LS4H) is a local solution to this gap in care, as it is an early stage 1 obesity intervention program to provide parents guidance on how to make these changes. The aim of this project is to determine if LS4H is a feasible program to successfully change behavior among families.
Methods:
Families in LS4H independently completed 1 module per week for 6 weeks that focused on movement, nutrition, or a new healthy behavior. Individual interviews were conducted weekly to assess family acceptance of the program and materials, impact on knowledge, changes in awareness or behaviors, and collect feedback on specific modules. Qualitative data analysis on 84 family responses were recorded using Qualtrics and themed into categories using spreadsheet software. Themes and patterns were identified from interviewer notes with multiple coders to ensure inter-coder reliability.
Results:
Of 66 families registered, 25 families completed at least one module including 13 families who completed all 6 or are still active. Major themes included changes in knowledge, awareness, and behavior for each module topic. The majority of families reported that they had met their "little step" module goal, but some acknowledged room for continued improvement. Across all 6 modules, 100% of families reported continuing the respective module behavioral goal as a new habit moving forward. Families also reported enjoying and engaging in the family activities guided by the modules.
Conclusion:
The results of this program demonstrated that the initial feasibility pilot was well received by families and majority were successfully able to change behaviors related to small goals. Ultimately, these small steps towards behavior change can gradually progress towards childhood weight loss. Future phases include collecting feedback on subsequent modules, assessing physician acceptability, and performing an efficacy/health outcome trial. If successful, the LS4H program can be integrated into the electronic medical record for physicians to provide families guidance in between follow-up care.