Steps to a Healthy Family: A multidisciplinary approach to childhood overweight and school wellness

Recognition of the extent to which child health related behavior is shaped by social and cultural norms and by the physical environment of the home, school and community has brought increasing attention to systems and environmental factors that contribute to health related behaviors. To impact childhood overweight on the US-Mexico border a Community Health Center in partnership with school nurses from two school districts developed and implemented the Steps to a Healthy Family (STAHF). STAHF is four phase, year long program, and targets families with significantly overweight children grades 3rd to 5th. Evidence based curriculum has been adapted to be cultural and linguistically salient for Mexican and Mexican American border families. Weekly, two hour bilingual sessions are delivered by a multidisciplinary team of nutritionist, psychologist and community health worker. In a family friendly learning environment, family communication strategies about healthy eating are introduced and supported by family-based physical activity. Advocacy for a healthy environment is encouraged through parent participation in parent-teacher organizations, attending school board meetings and volunteering in school or community efforts to improve health and wellness. In partnership with community health center pediatricians, community health workers collect clinical and behavioral measures fro child and participating parent at baseline, 6 months and 12 months. Program outcome measures, process indicators, and lessons learned including issues in health care access will be shared. Preliminary data suggests that 54% of participants were uninsured and underinsured at baseline; this school-clinic partnership is a promising practice to increase the health access children and families.