School-Based Versus Family-Based Interventions for the Reversal and Prevention of Obesity Among Hispanic Youth: a Review of the Literature

Childhood obesity prevalence in the USA continues to rise and the Hispanic American population is disproportionately affected. Obesity prevalence among Hispanic youth is 26.2%, the highest prevalence of any minority or non-minority group of children. Prevalence of related conditions including type 2 diabetes, heart disease, and stroke also are increased among Hispanic Americans. Physicians and other providers commonly utilize body mass index (BMI) to estimate percentage of bodily fat and risk of adverse health outcomes. BMI has been shown to track from childhood to adulthood, demonstrating necessity for early intervention. Interventions targeting the prevention and reversal of obesity among children are categorized as school-based or family-based. Interventions vary but may involve strategies such as meetings to discuss health-related curriculum, augmentation of physical activity, and/or improvement of nutritional quality of food. The aim of this article is to review the current literature to determine whether family-based or school-based interventions are more successful in the prevention and reversal of obesity among Hispanic youth. We reviewed twenty-eight studies describing these interventions and included ten (four school-based and six family-based) in our in-depth analysis. Inclusion criteria required trials were conducted among adequate population sizes of Hispanic youth within the age range of interest, analyzed the primary outcome of interest, and took place after the year 2000. Family-based interventions typically involved small population sizes, were dependent upon parent adherence, and were rarely effective. School-based interventions were more commonly effective and involved larger population sizes, allowing for greater generalizability and greater impact of the intervention. Of five family or school-based interventions which successfully reduced BMI among this population, four included a component involving structured physical activity. School-based interventions involving augmentation of physical activity with minimal limitations of study execution demonstrated efficacy in the prevention and reversal of obesity among Hispanic children.