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American Journal of Clinical Nutrition, Vol. 69, No. 4, 803S-809S, April 1999
© 1999 American Society for Clinical Nutrition


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Pathways family intervention for third-grade American Indian children1,2,3

Nicolette I Teufel, Cheryl L Perry, Mary Story, Hilary G Flint-Wagner, Sarah Levin, Theresa E Clay, Sally M Davis, Joel Gittelsohn, Jackie Altaha and Juanita L Pablo

The goal of the feasibility phase of the Pathways family intervention was to work with families of third-grade American Indian children to reinforce health behaviors being promoted by the curriculum, food service, and physical activity components of this school-based obesity prevention intervention. Family behaviors regarding food choices and physical activity were identified and ranked according to priority by using formative assessment and a literature review of school-based programs that included a family component. The family intervention involved 3 primary strategies designed to create an informed home environment supportive of behavioral change: 1) giving the children "family packs" containing worksheets, interactive assignments, healthful snacks, and low-fat tips and recipes to take home to share with their families; 2) implementing family events at the school to provide a fun atmosphere in which health education concepts could be introduced and reinforced; and 3) forming school-based family advisory councils composed of family members and community volunteers who provided feedback on Pathways strategies, helped negotiate barriers, and explored ideas for continued family participation. For strategy 2, a kick-off Family Fun Night provided a series of learning booths that presented the healthful behaviors taught by Pathways. At an end-of-year Family Celebration, a healthy meal was served, students demonstrated newly learned Pathways activities, and certificates were presented in recognition of completion of the Pathways curriculum. Based on evaluation forms and attendance rosters, strategies 1 and 2 were more easily implemented and better received than strategy 3. Implications for developing family involvement strategies for intervention programs are discussed.

Key Words: Family • children • parents • health promotion • health education • nutrition intervention • obesity prevention • American Indians • low-fat diet • physical activity • exercise • health attitudes • health behaviors




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