zeviar home project
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The HOME Project – Prevention of Childhood Obesity Dorothy D. Zeviar, Ed.D., LAc
Department of Community and Family Health
Background and Significance
• Childhood obesity doubled in past 30
years
• Childhood obesity increased from 6%
to 19% among 6-11 years old
• Childhood obesity increased from 5%
to 18% among 12-19 years old
• Over 17% of child population
is overweight or obese
• Highest prevalence among African-
American, Hispanic and Native American
children
Purpose of Intervention To prevent childhood obesity by
increasing parental efficacy for meal-
planning and cooking, and increase
family meals eaten together at home
Intervention Goals • Increase the number of weekly family
meals eaten together at home
Facilitate parent/child interactive classes on
meal-planning and cooking
Demonstrate easy-to-prepare meals that
take < 30 mins to prepare
Demonstrate how to add fruits, vegetables,
and whole grains to recipes
Healthy Life Tips. Retrieved from
http://www.katrinatribute.info/childhood-obesity-
graphs-warns-us-of-future-problems.html
Theoretical Frameworks and
Project Description
Reciprocal determinism --
The individual, the behavior and the
environment all impact and influence
each other in a mutual process
Choosing locations to sponsor the
HOME project which are in selected
Tampa neighborhoods, affiliated with
neighborhood schools, churches, or
recreational facilities/clubs, and
recruiting instructors which match the
demographics of the target population.
Psychological determinants –
How confident the person is with
making correct choices, how s/he will
feel after making the choice, and
whether everyone in the referent group
feels competent at making the same
choices. Self-efficacy is the
cornerstone of this construct
Focusing on the value of “Families
come First,” how family values are
reinforced through meals together at
home, reinforcing how learners can
easily learn to plan and prepare a
healthy and low-cost meal at home,
and recognizing others’ affirmations of
ability to complete the task
Environmental determinants –
The rewards and motivations to
encourage the behaviors, and the
degree to which making these choices
is facilitated by the project
Having access to a health educator by
phone or email, providing free targeted
cookbooks for participants, and having
a large “family dinner” celebration at
the end of the project
Observational learning –
The presence of role models similar to
the neophyte practicing the new
behaviors, and cultural institutions that
reinforce desired behaviors
Having dyads of parent/child learners
learn not only from the instructor, by
from each other and also from the
other dyads. Inclusion of “ethnic”
recipes that reinforce healthy “Families
come First”
Self-regulation –
A way of rewarding and reinforcing
oneself for performing the behavior
such that intrinsic motivators are
stronger than extrinsic, and more likely
to reinforce healthy behaviors over
time.
By giving step-by-step “homework”
each week that focuses on choosing a
recipe, making a shopping list, and
coming to class to learn how to
prepare the recipe, learners will self-
reinforce that they can easily perform
the task. With social support from
other family members, learners will
feel validated in their abilities
Table 1. Social Cognitive Theory Elements of the HOME Project
“Families Come First”
Social Reciprocity –
Mutual support and resources are
given and shared in perceived equal
value
Dyads working together provide both
social time together for an activity that
benefits both – a healthy meal cooked
together
Emotional support –
Both parent and child demonstrate
mutual love and respect when both
can accomplish an activity that is
mutually beneficial
Dyads working together provide an
opportunity to do a new activity
together and bond over food cooked
and consumed together. Frequent
praising is part of the classroom
culture
Instrumental support –
Provision of tangible aid and support to
the neophyte’s early attempts to try a
new skill
Having the instructor/facilitator right
there in the class providing hands-on
guidance for how to plan and make a
healthy meal creates the conditions for
success. Having easy phone or web-
site access to another facilitator or
health educator increases access to
instrumental support. Frequent
statements of praise are part of the
process
Informational support –
Provision of information, advice or
suggestions to help learners
successfully practice a new skill
The instructor/facilitator is right in the
classroom providing advice and
suggestions for dyads to successfully
accomplish the task. A culturally-
appropriate recipe book filled with low-
cost meal-planning ideas and meals
that take under 30 minutes to cook is
given as part of class enrollment.
Guidance will also be provided on how
to increase the nutritional value of
recipes through the addition of fruits,
vegetables, and whole grains as
appropriate.
Appraisal support –
Constructive feedback and affirmation
of participants’ efforts to plan and cook
meals
The instructor/facilitator continuously
provides constructive feedback and
praise to participants as they learn and
practice new skills. The culture of the
learning environment is positive,
constructive and encouraging.
Table 2. Social Network Theory Elements of the HOME Project
Conclusion • Although obesity is a multi-faceted problem in America, beginning with small steps at the inter-personal (family)
level is the best and most direct way to influence healthy behaviors of children and thus reduce the prevalence of
childhood obesity.
• Families don’t enjoy mealtimes together as often as in the past due to busy lifestyles, no time to plan and cook
meals, and lack of skills associated with planning and cooking.
• This project attempts to minimize these barriers through the use of hands-on learning and observational
learning, provision of culturally-appropriate recipes, “field trips” to the local supermarket and Farmer’s Market,
and lots of positive reinforcement.
• By learning and cooking meals together, the family structure is supported and reinforced, healthful childhood
eating preferences are established, childhood overweight is reduced, and good habits are learned early and
carried throughout adolescence and into adulthood.
References Bandura, A. (1977). Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall.
Bandura, A. (1997). Self-efficacy: The Exercise of Control. New York, NY: W.H. Freeman.
CDCa. (2010). Childhood Overweight and Obesity. Retrieved from http://www.cdc.gov/healthyyouth/obesity
CDCb. (2010). Childhood Obesity. Retrieved from http://www.cdc.gov/healthyyouth/obesity
Fulkerson, J., Rydell, S., Kubik, M., Lytle, L., Boutelle, K., Story, M., Neumark, D., … & Garwick, A. (2010). Healthy home offerings via the
Mealtime Environment (HOME): Feasibility, acceptability, and outcomes of a pilot study. Obesity, 18, S69-S74. doi: 10.1038/oby.2009-434
Heaney, C., & Israel, B. (2008). Social networks and social support. In K.Glanz, B.Rimer, & K.Viswanath, (Eds.), Health Behavior and Health
Education, 4th ed. (pp. 189-210). San Francisco, CA: John Wiley & Sons.
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