Technical Assistance (TA) Corner: March 2021

Child Obesity Prevention Efforts: Solutions from Families and Communities

March is National Nutrition Month, which focuses on the importance of making informed food choices and developing sound eating and physical activity habits. The Center provides TA on many topics, including nutrition. The Bright Spots Mini-Lab Positive Deviance Project is one example that is bringing collaborative training and experiential learning opportunities for MCH students, faculty, Title V staff and others interested in exploring positive deviance approaches in child obesity prevention efforts.

What is positive deviance?

Positive deviance approaches focus on identifying and using resources that already exist within families or communities. People can then utilize these resources to develop strengths-based programs and services; in our case, for other families of young children at risk for obesity who live in similar communities.

At the heart of our project is the goal of increasing a shared understanding of strategies associated with lower risk of obesity in historically underserved children and communities, while simultaneously sharing asset-based, community-derived, promising strategies with MCH programs, service providers and community agencies.

What is involved in this work?

A team of faculty and students affiliated with the Leadership, Education and Training (LET) Program in MCH Nutrition and Center for Leadership Education in Maternal and Child Public Health, and MN Department of Health (MDH) staff, participated in a series of trainings and consultations on positive deviance research and qualitative research methods. Partners from MDH learned side-by-side with UMN students and faculty, to assure all partners are similarly and equally trained.

The trainings took place concurrently with the development of our qualitative research “Mini-Lab.” The Mini-lab provided access to cutting edge research and data management software and other equipment required to conduct formative research that inform the development of positive deviance messages for families of young children.

To allow for application of the positive deviance and qualitative research skills, MDH staff and UMN faculty and students conducted a pilot study of positive deviance behaviors related to child obesity prevention among parents of preschool-aged children from diverse communities. To do this, in-home interviews with parents of children who are obese and who are not obese were completed. In-home interview questions were determined by the team, and informed by a review of the literature and in consultation with experts in the field.

Primary caregivers of obese and non-obese children from Black, Hispanic and Hmong families were selected and matching on characteristics such as age and neighborhood (zipcode, WIC clinic) to account for potential social and environmental factors, such as access to food and physical activity venues. In-home interviews were also conducted in Spanish and Hmong and translated during transcription for analysis (using NVivo software). Analyses of results are nearly completed and results of the pilot project will be presented at a national MCH nutrition conference in July 2021.

What are the take-aways?

Results of the study will be translated into plain language messages that will be shared with WIC and home visiting programs and other agencies serving MCH populations, such as Peer Breastfeeding Promotion Programs, the Family Home Visiting Program, Healthy Start and Head Start.

The team plans to share positive deviance practices and is developing briefs and presentations in order to do so (stay tuned to the Center’s enews for updates!).

What’s inspiring about this work?

There is a lack of understanding of culturally-specific factors that may affect the development of obesity among young children. Most interventions are based on altering behaviors that may place children at risk for obesity and are based on negative or deficit messages (e.g. “don’t do this”, “limit that”). Deficit-based messages may not engage people to make behavior changes.

There is also lack of data on factors that may protect young children from obesity, particularly culturally-specific beliefs and behaviors that may be protective. A better understanding of such factors could lead to the development of positive, asset-based messages, which may be more engaging for families, especially if they are culturally tailored messages.

Finally, as a result of this project, the team continued to gather regularly (now virtually) with Mini-Lab faculty and trainers for informal, small-group training sessions that provide ongoing opportunities to consult with experts and strengthen their skills.

Who makes up the positive deviance team?

–MDH members: Heidi Jonson, Kate Franken, Joni Geppert, Rebecca Gruenes, and Marcia McCoy

–MCH and MCH Nutrition students: Ashley Ansolabahar (MPH 2019), Elizabeth Stanczyk (MPH 2019), Junia Nogueria de Brito (PhD candidate) ,Kalia Thor (MPH 2018), Laura Hooper (PhD candidate), Laura Villarreal (MPH 2021), Lauren Pringle (MPH 2021), Marianna Colucci (MPH 2020), Moko Matsumoto, Noelle Yeo (MPH 2019), Somadee Cheam (MPH 2029), Toluwani Awokoya (MPH 2021), and Yetundi Akingbemi (MPH 2019)