Adapting an Intervention to Promote Healthy Eating and Prevent Weight Gain among 2-1-1 Clients through Improved Home Food Environments

? DESCRIPTION (provided by applicant): Adapting an Intervention to Promote Healthy Eating and Prevent Weight Gain among 2-1-1 Clients through Improved Home Food Environments Given the magnitude of the obesity epidemic in the U.S. and the difficulty of losing and then maintaining weight loss, preventing weight gain in the first place is an appealing public health strategy for prevention of cancer and other chronic diseases. Current public health efforts to address the obesity epidemic focus on increasing access to healthy foods and opportunities for physical activity, as well as individual behavior change. While clearly important, much less attention has been focused on the home as a setting that shapes weight-related behavior. Few interventions have targeted the home environment for adult obesity prevention despite the fact that a significant amount of time is spent at home and over 2/3 of calories are consumed from foods prepared in the home. Our team has developed and tested an intervention to prevent weight gain through changes in the home food environment. The intervention, called Healthy Homes/Healthy Families, succeeded in changing numerous features of the home food environment and reducing energy intake in a sample of low-income, largely African American women. Changes were sustained for 12-months. We are proposing to adapt this intervention for eventual dissemination through the national 2-1-1 infrastructure. The 2-1-1 information and referral system consists of over 200 non-profit state and local call centers operating in all 50 states and connects over 16 million callers per year to local health and social services. Callers to 2-1-1 are disproportionately low-income, unemployed, uninsured, and have fewer years of education relative to the general population. 2-1-1 is unique in its extensive reach to populations at particular risk for weight gain and obesity. Our team has partnered with eight 2-1-1 systems around the U.S. in a series of studies to promote smoke-free homes. We seek to leverage this strong collaborative infrastructure to address the obesity epidemic. Our specific aims for this proposal are to: 1) adapt an effective home food environment intervention, Healthy Homes/Healthy Families, for telephone-based delivery in collaboration with United Way of Greater Atlanta 2-1-1; 2) Conduct a pilot study to test feasibility and acceptability of the Health Homes/Healthy Families intervention among United Way of Greater Atlanta 2-1-1 callers and identify effect sizes for a larger efficacy trial. Our next step will be to conduct an efficacy tril to rigorously test the adapted intervention for delivery through 2-1-1. Obesity and excess weight increase the risk of multiple chronic diseases, including cancer. Developing a scalable weight gain prevention intervention with the potential for widespread dissemination will fill a notable ga in our efforts to prevent cancer through obesity prevention.