Our health, our future: Development of a video for Hmong families to prevent childhood overweight

Childhood overweight and obesity, known to increase the adult risk for chronic diseases like diabetes, is on the rise in Hmong communities of California's Central Valley. Contributing factors include an acculturation process that frequently devalues healthy traditional diet patterns, an environment that reinforces overweight-related behaviors during school, work, and play, and a lack of culturally competent health education in an effective medium. In response, a community-based health promotion project grounded in Social Cognitive Theory (SCT) and informed by Kreuter's model of health communication was undertaken to develop a short video to empower parents with practical strategies for healthy eating and exercise. Parents were recruited through a church group and community agencies and participated in three focus groups and six individual interviews. Knowledge, attitudes, and behaviors around diet, exercise and parenting were analyzed to identify the most salient messages and preferred methods of delivery. Results indicated: pressures to accommodate an increasing demand for unhealthy American foods and drinks; difficulty eating meals together due conflicting schedules; a lack of time and resources for exercise; and that the most effective approach would be family-based. The project used a story format of linked segments showing how to overcome barriers with small, doable actions and Hmong peers participated as convincing role models to advocate for self-efficacy and positive change. Testing of the video has suggested that this approach is not only a promising tool for raising awareness about preventing chronic disease in vulnerable populations—it also helps ease the challenges of low health literacy.