Healthy Homes/Healthy Families

Summary

The Healthy Home/Healthy Families intervention is a 16-week health coach-delivered intervention to reduce energy intake for the prevention of weight gain among predominantly rural African American women who are overweight or obese. The intervention uses tailored home environment profiles showing areas in need of improvement and positive aspects of the home environment, behavioral contracts for healthy actions, and mailed support materials. The intervention resulted in significant decreases in energy intake and self-reported weight gain compared to women in the control condition.

Overview

Purpose of Intervention:

To reduce energy intake to prevent weight gain through improved home environments for rural residents

Intervention Type:

Research-Tested — Interventions with strong methodological rigor that have demonstrated short-term or long-term positive effects on one or more targeted health outcomes to improve minority health and/or health disparities through quantitative measures; Studies have a control or comparison group and are published in a peer-review journal; No pilot, demonstration or feasibility studies.

Intervention Details

Intervention was Primarily Driven, Led, or Managed by:

Both Community and Academic/Clinical Researchers

Citations:

Kegler MC, Haardörfer R, Alcantara IC, Gazmararian JA, Veluswamy JK, Hodge TL, Addison AR, Hotz JA. Impact of Improving Home Environments on Energy Intake and Physical Activity: A Randomized Controlled Trial. American journal of public health. 2016 Jan;106(1):143-52. PubMed PubMed Central DOI
Relevance: Main Intervention
Woodruff RC, Haardörfer R, Gazmararian JA, Ballard D, Addison AR, Hotz JA, Tucker RB, Kegler MC. Home Environment-Focused Intervention Improves Dietary Quality: A Secondary Analysis From the Healthy Homes/Healthy Families Randomized Trial. Journal of nutrition education and behavior. 2019 Jan;51(1):96-100. Epub 2018 Sep 18. PubMed DOI
Relevance: Post-Intervention Outcomes

Adaptation of Another Research-based Intervention:

No

Contact Information

Primary Contact Affiliation:

Emory Prevention Research Center

Intervention URL:

https://web1.sph.emory.edu/eprc/dissemination/healthy-homes.html

Results

Intention

Improve minority health or the health of other populations with health disparities (e.g. rural populations, populations with low SES)

Intervention Primary Outcome:

Energy intake

Intervention Secondary Outcome:

Energy expenditure, moderate/vigorous physical activity, healthy eating index, and home environment

Key Findings:

Significant decrease in energy intake: -274 intervention vs -69 control (p=.03) at six months; -195 verses -76 at 12 months (p=.09). Intent to treat was statistically significant through growth modeling using both six and 12 month data (p=.03). No change in moderate/vigorous physical activity. Self-reported weight loss: -9.1 pounds intervention vs -5 pounds control (p=.03) at six months and in intent to treat analysis. Healthy eating index: 3.4 intervention versus 2.0 control (p=.009) at six months. There were multiple significant changes in the home environment for both food and physical activity at six months, 12 months, and in intent to treat.

Statistical Method Used:

Growth modeling in the intent to treat analyses at 12 months. Methods varied for six and 12 month analyses, where independent t-tests or Wilcoxon-Mann-Whitney tests were used depending on each variable.

Demographic and Implementation Description

Diseases, Disorders, or Conditions:

Obesity, Nutrition, Physical Activity, Weight Management

Race/Ethnicity:

African American or Black, White

Populations with Health Disparities:

People with Lower Socioeconomic Status (SES), Racial and Ethnic Minority Populations, Underserved Rural Communities

Age:

Young Adults (18 - 39 years), Middle-Aged Adults (40 - 64 years)

Characteristics and Implementation

Intervention Focus Area:

Behavior Change, Physical Environmental Change

Disease Continuum:

Primary Prevention, Secondary Prevention

Delivery Setting:

Home

Mode of Delivery:

In-person, Telephone and mailed environmental supports

Who delivered the Intervention?:

Community Health Worker/Promoters, Trained community members (but not formal community health workers)

Impact, Lessons, Components

Produced an impact or change beyond the primary or secondary outcome:

No

Essential Aspects for Success:

There are four core components of this intervention: tailored home environment profile (this involves using our web-based platform which we provide access to for free); healthy actions; six coaching sessions; and behavioral contract.

Products, Materials, and Funding

Expertise, Partnerships, and Funding Sources

	Used for Implementation	Needed for Sustainability
Expertise
Health Education / Health Literacy	Yes	Yes
Partnerships
Health care facilities (local clinics)	Yes	No
Community groups (e.g. faith-based organizations, barbershops, beauty-salons, laundromats, food markets, community centers, cultural associations, tribal groups)	Yes	Yes
Funding Sources
Public funding (e.g., federal, state or local government)	Yes	Unknown

Product/Material/Tools

	Tailored For Language	Material
Outreach/Recruitment Tools
Publicity Materials (e.g. Posters, Flyers, Press Releases)	No	Attachment available for request at the bottom of the page.
Participant Educational Tools
Healthy Actions (core component)	No	https://web1.sph.emory.edu/eprc/dissemination/healthy-homes.html
Measurement Tools
Non-Standardized Instruments/Surveys/Questionnaires	No	Attachment available for request at the bottom of the page.

Implementation Materials and Products

	Material
Implementation/Delivery Materials
Training/Operations manual	Attachment available for request at the bottom of the page.
Implementation/Output Materials
Infographic summarizing study findings	Attachment available for request at the bottom of the page.

Articles Related to Submitted Intervention

	Article
Reports/Monographs
No Reports/Monographs provided.
Additional Articles
Evaluation	https://pubmed.ncbi.nlm.nih.gov/30241706/
Adaptations	https://pubmed.ncbi.nlm.nih.gov/32658029/
Evaluation	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695922/

Materials Available for Request

HHHF flyer 2.pdf
Home Environment Survey.pdf
HHHF Implem Guide 2.1.23_Final.pdf
HH-HF-Infographic 2020.pdf

Intervention IP-091: Healthy Homes/Healthy Families