Grant Number:	1R01CA289519-01 Interpret this number
Primary Investigator:	St. George, Sara
Organization:	University Of Miami School Of Medicine
Project Title:	Efficacy Trial of Healthy Juntos: a Family-Based Digital Lifestyle Intervention for Hispanic Adolescents and Their Parents
Fiscal Year:	2024

PROJECT SUMMARY Obesity, physical inactivity, and poor diet are major modifiable risk factors for cancer — a leading cause of death among US Hispanics. US Hispanic youth have the highest rates of pediatric obesity and show faster increases in body mass index (BMI) from age 12 to <20 years than non-Hispanic Whites. Most Hispanic adults also carry excess weight, and Hispanic youth and adults do not often meet national guidelines for physical activity and dietary intake. Family-based interventions can improve health outcomes in both youth and parents and are highly relevant to Hispanics due to the cultural value of familismo (familism). However, very few existing family-based obesity prevention interventions for Hispanics target adolescents and their parents, and those that do are not designed to facilitate widespread reach. An underutilized approach for promoting a healthy weight status among Hispanics is through digital (i.e., eHealth/mHealth) interventions. US Hispanics are just as likely as non-Hispanic Whites to own a smartphone and more likely to be smartphone-only internet users. Our team employed a user- centered approach to develop and pilot a family-based digital lifestyle intervention known as Healthy Juntos (Healthy Together). This innovative six-month intervention (three-month intensive phase; three-month maintenance phase), grounded in family systems and behavioral theories, is one of the few obesity prevention interventions for Hispanic adolescents with digital delivery. It targets improvements in parent BMI and lifestyle behaviors, family functioning, and health-related positive parenting practices as the means through which adolescent BMI and lifestyle changes are hypothesized to occur. Unlike existing digital interventions for adolescents, the intervention makes parents the primary agents of change, with parent-adolescent participation a team effort through shared decision-making. Given promising findings for Healthy Juntos, the primary goal of this study is to evaluate, in a randomized controlled trial with 375 Hispanic adolescents and their parents, the efficacy of Healthy Juntos compared to a digital health referral to publicly available websites and apps (control) condition in preventing increases in BMI and improving moderate-to-vigorous physical activity (MVPA) and diet quality among adolescents. The aims of the study are: AIM 1: To determine whether participation in Healthy Juntos prevents increases in BMI (primary outcome) and improves MVPA, diet quality, and percentage body fat (%BF; secondary outcomes) in Hispanic adolescents. AIM 2: To examine whether and to what extent changes in parent BMI and lifestyle behaviors mediate the effects of Healthy Juntos on adolescent outcomes. AIM 3: To examine whether and to what extent family functioning and health-related positive parenting practices mediate the effects of Healthy Juntos on adolescent outcomes. We will also explore the role of sociodemographic (e.g., acculturation, adolescent sex, weight status, neighborhood deprivation) and user engagement as moderators as well as the mediating effects of individual-level constructs (e.g., self-efficacy, autonomous motivation).





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