Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspectives

• Published in: Maternal and child health journal 2018-11, Vol.22 (11), p.1589-1597
• Main Authors: Knierim, Shanna Doucette, Moore, Susan L., Raghunath, Silvia Gutiérrez, Yun, Lourdes, Boles, Richard E., Davidson, Arthur J.
• Format: Article
• Language: English
• Subjects: Body Mass Index; Child, Preschool; Childhood; Childhood obesity; Colorado; Content analysis; Curricula; Diet; Exercise; Female; Gynecology; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; House Calls; Humans; Male; Maternal and Child Health; Medicine; Medicine & Public Health; Obesity; Outcome and Process Assessment (Health Care); Overweight - ethnology; Overweight - therapy; Parenting; Patient Navigation - organization & administration; Pediatric Obesity - ethnology; Pediatric Obesity - therapy; Pediatrics; Population Economics; Prevention; Program Evaluation; Public Health; Qualitative Research; Sociology; Wellness programs
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-018-2553-7

Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator’s role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore.