Intergenerational health promotion in African-Americans

Abstract

Heart disease is the leading cause of death for people over the age of 25 and is largely preventable through behavioral changes. Diet and physical activity patterns, which may be amenable to change through age- and generation-appropriate interventions, have not been extensively tested in school-based programs. The purposes of this study were to: (1) Assess the impact of a school-based intervention in promoting healthy cardiovascular behaviors in elementary school children; and, (2) Evaluate the efficacy of elementary school children as conduits of health promotion information for older generations. Three inner city public elementary schools located within a one mile radius were randomly assigned to treatment or control groups. Individual participants were six classes of African-American students (n = 135) and their grandparent partners (n = 44). The four-week intervention incorporated workshops from Heart Power!TM with take-home activities to be shared with the grandparent partner. Constructs from the Intergenerational Health Promotion Model guided the development of the instruments and the intervention. Self-report measures assessed the effectiveness of the intervention: the Family Health Tree (FHT), the Heart Healthy Questionnaire (HHQ), the Physical Activity Record, and the 24-hour Food Record. A significant effect for the intervention was found for the knowledge of a heart healthy diet and physical activity in one of the two intervention schools (School B) (ANCOVA) (F (2.94) = 5.77, p=0.004). Although there were no significant treatment effects on attitudes, self-efficacy, or stages of change subscales, scores from the two intervention schools were higher than those of the control school. There were no significant differences among grandparents of students from the three schools on any of the variables. Overall, scores were higher for physical activity behaviors than nutrition behaviors. Sixty-six percent of the students in the intervention schools participated with their partners in one or more take-home workshop activities, with the greatest participation (88%) from School B. Since cardiovascular risk factors originate early in life, interventions through school-based programs are a promising mechanism for educating an entire family or kinship network in a community about heart healthy lifestyle behaviors as supported by the sharing of information across generations.