Barriers to an integrated family-based health promotion program in Harlem

Researchers at Mount Sinai Heart conducted a qualitative study to identify factors that may affect the implementation of an integrated family-based health promotion program for children aged 3-5 years old and their caregivers in Harlem, known as the FAMILIA Project. An abstract of the study was presented this week at the American Heart Association (AHA)'s Scientific Sessions 2015 in Orlando, Florida.

The FAMILIA Project is the brainchild of world-renowned cardiologist Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital. Mount Sinai Heart is ranked No. 7 in the nation by U.S. News & World Report in its 2015 "Best Hospitals" issue.

Dr. Fuster's initiative is made possible thanks to $3.8 million in grant support to Mount Sinai Heart by the AHA. For the FAMILIA Project, Mount Sinai has partnered with NYC's Administration for Children's Services (ACS), Division of Early Care and Education Head Start programs.

The Harlem area of New York City (NYC) has among the highest obesity and diabetes prevalence rates in the city. Nearly half of the children in Head Start programs and about 94 percent of adults are overweight or obese. NYC's new four-year, early-heart health education and assessment project is enrolling 600 children ages 3-5 in eight of NYC's Head Start preschool programs in the high-risk community of Harlem, along with 1,000 of their caregivers to improve nutritional and lifestyle knowledge, health, and habits of children and their families.

Researchers from The Mount Sinai Hospital conducted five focus group discussions at two Head Start preschool centers in Harlem, to determine potential barriers toward implementing an integrated family-based health promotion program. The focus groups included 25 parents, teachers, directors, educational directors, nutritionists, cooks, and mental health and social service professionals.

According to lead investigator Sameer Bansilal, MD, MS, Assistant Professor of Cardiology at The Mount Sinai Hospital, "We identified seven potential themes that might act as barriers to the successful implementation of an integrated family-based health program for young children and their . We then identified actions that will successfully address these barriers during program implementation. The researchers at The Mount Sinai Hospital believe this type of approach may have relevance for other programs in similar settings."

The seven identified themes are:

  • knowledge regarding social determinants of chronic diseases
  • knowledge and perceptions regarding childhood obesity
  • impact of stress on health
  • impact of media and advertising on health choices
  • perception regarding researchers
  • incentives for healthy behaviors and choices
  • cultural and social sensitivity

Abstract 322 was presented at the AHA Scientific Sessions 2015 as Barriers to Implementation of an Integrated Family-based Health Promotion Program in Harlem, New York: The FAMILIA study- an AHA Strategically Focused Research Network Study.


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