Healing Experiences of Adversity Among Latinos (HEALthy4You)

Study Overview
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Brief Summary
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Healing Experiences of Adversity Among Latinos (HEALthy4You) is a project funded by the California Initiative for the Advancement of Precision Medicine (Advancing a Precision Population Health Approach to ACEs to Reduce Health Disparities). The long-term goal of this project is to develop community-centered, culturally Appropriate, precision Interventions that can be delivered within Federally Qualified Healthcare Centers (FQHCs) for Latino Families, to reduce Adverse Child Events (ACES) risks and treat childhood obesity. UCSD in conjunction with Family Health Centers of San Diego (FHCSD) will conduct a 2x2 factorial trial with four groups meant to determine what combination of intervention components influence family protective factors (a key marker for reduced risk of the deleterious effects of systemic and family/individual stressors that are a critical part of ACEs) and childhood obesity.

Official Title
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Healing Experiences of Adversity Among Latinos (HEALthy4You)

Conditions
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Stress, Childhood Obesity

Intervention / Treatment
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* Behavioral: Healthy Together (Control)
* Behavioral: Healthy Together + Promotora Support
* Behavioral: Healthy Together + Parenting Training
* Behavioral: Healthy Togethers + Parenting Training + Promotora support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child Currently a patient at Family Health Centers of San Diego Age 5-11 years old BMI ≥ 85th percentile to 99.9th percentile Social determination or risk for ACE determined as being a patient receiving care at an FQHC (confirmed via provider) Parent Parent or guardian (including non-biological parent or relative) willing to participate Self-identification as Hispanic or Latino 18 years or older English or Spanish speaking Willingness to commit to 6 months of the program Exclusion Criteria: Serious Developmental Disability (parent or child) Serious Mental Health Illness (parent or child)

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 11 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Healthy Together (includes Streetwyze) (Control/Standardized Care)<br>Control - standardized Healthy Together program: The Healthy Together Program is not standard of care at Family Health Centers (FHC). Instead, it was originally developed by FHC clinicians interested in addressing childhood obesity and has been implemented by a limited number of clinicians at FHC. UCSD has been working in partnership with FHC to create standardized protocols and to incorporate additional research-oriented tools into this standardized protocol, which will be used as our experimental control. | Behavioral: Healthy Together (Control)<br>* The total number of sessions families will engage with will be negotiated between the Families and their Care providers. This allows for families to receive care while still honoring their constraints, such as the amount of time they can dedicate per week and over the course of the study, to the intervention. The maximum number of possible sessions include: 6 Sessions with a Wellness Coach 4-8 sessions with a Dietician 4-8 sessions of Physical Theraphy 1 session during month 1 or 2 Streetwyze Training Safety Net Referrals<br>|
| Active Comparator: Healthy Together + Promotora support<br>In addition to the basic program described above, those randomized to this intervention will receive Promotora support. Families assigned to a promotora will receive 30-60 minutes of phone-based support weekly, with more frequent interactions that will taper starting at month 3 of the intervention. Promotoras may also provide home-visit support up to 4 times during the 6 months, based on family interest and needs. The wellness coach will try to minimize in-person meetings with FHC professionals each week and space out visits to reduce burden on families. For families in this condition, they will be asked to engage in at least 30 minutes of additional sessions per week with the promotora beyond the 1- hour allotted time working with FHC professionals. | Behavioral: Healthy Together + Promotora Support<br>* The total number of sessions families will engage with will be negotiated between the Families and their Care providers. This allows for families to receive care while still honoring their constraints, such as the amount of time they can dedicate per week and over the course of the study, to the intervention. The maximum number of possible sessions include: 6 Sessions with a Wellness Coach 4-8 sessions with a Dietician 4-8 sessions of Physical Theraphy 1 session during month 1 or 2 Streetwyze Training Safety Net Referrals 16-20 Promotora (in home case management) Sessions (weekly first 2 months, afterwards at least bi-weekly)<br>|
| Active Comparator: Healthy Together + Parenting training<br>In addition to the basic program described above, those randomized to this intervention will attend Parenting Training sessions with the mental health provider at FHC. Families assigned to parenting training will receive 10-12 sessions. Sessions will focus on topics like strategies to support the child's physical, social, and emotional growth. The wellness coach will try to minimize in-person meetings with FHC professionals each week and space out visits to reduce burden on families. | Behavioral: Healthy Together + Parenting Training<br>* The total number of sessions families will engage with will be negotiated between the Families and their Care providers. This allows for families to receive care while still honoring their constraints, such as the amount of time they can dedicate per week and over the course of the study, to the intervention. The maximum number of possible sessions include: 6 Sessions with a Wellness Coach 4-8 sessions with a Dietician 4-8 sessions of Physical Theraphy 1 session during month 1 or 2 Streetwyze Training Safety Net Referrals 6-10 Parenting Sessions with a Family Health Centers Mental Health Provider using the Incredible Years Curriculum<br>|
| Active Comparator: Healthy Togethers + Parenting Training + Promotora support<br>Those randomized to this intervention will receive all components described above including the Healthy Together Program, Parenting Training and Promotora support. The wellness coach will try to minimize in-person meetings with FHC professionals each week and space out visits to reduce burden on families.. Families in this group will also be asked to engage in at least 30-60 minutes of additional sessions per week including up to 4 home visits. | Behavioral: Healthy Togethers + Parenting Training + Promotora support<br>* The total number of sessions families will engage with will be negotiated between the Families and their Care providers. This allows for families to receive care while still honoring their constraints, such as the amount of time they can dedicate per week and over the course of the study, to the intervention. The maximum number of possible sessions include: 6 Sessions with a Wellness Coach 4-8 sessions with a Dietician 4-8 sessions of Physical Theraphy 1 session during month 1 or 2 Streetwyze Training Safety Net Referrals 16-20 Promotora (in home case management) Sessions (weekly first 2 months, afterwards at least bi-weekly) 8-10 Parenting Sessions with a Family Health Centers Mental Health Provider using the Incredible Years Curriculum<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Parents' Assessment of Protective Factors Self-Report Scale (comparison baseline to 6-months) | Parents' Assessment of Protective Factors (PAPF) Instrument consists of 36 items to measure the presence, strength, and growth of parents' self-reported beliefs, feelings, and behaviors that are regarded as indicators of the Strengthening Families protective factors using a 5-point response system from Not at all like me to Very much like me (Score scale: 0 Low - 3.99 High) | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes to Child Body Mass Index (BMI) from baseline to 6 months | Weight and height will be combined to report BMI in kg/m^2. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ACEs, Obesity, Adverse Childhood Experiences, 2x2 Factorial Study, Behavioral Intervention, Health Education, Healthy Together, Parenting, Protective Factors, Precision Medicine, Federally Qualified Health Centers, Latino, Hispanic, Pediatric, Whole Child Wellness