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London is home to one of the fastest-growing Latin American communities in Ontario. It is estimated that 35% of Latin American children in London are overweight and 24% are obese—more than double the proportions of children from the general population in London. The prevention of obesity is recognized as a critical step in the prevention of type 2 diabetes. Compared with the general population's rate of type 2 diabetes, the rate for Latin American adults is three to four times higher. It is estimated that children with parents who have diabetes are twice as likely to get diabetes as those whose parents do not have the disease.
The Families in Action (FIA) Program was designed to address the needs of the Latino population in London by identifying those children at greatest risk of developing obesity-related health consequences, such as diabetes.
The program included both a screening component and a six-month intervention component for children and families identified as high risk.
Recruitment and diabetes screening events were held in local community centres and churches. Children's height and weight were measured and used to calculate body mass index (BMI). Those with a BMI above the 85th percentile for their age and gender were invited to participate in the intervention. Information was collected on family history, nutrition and physical activity habits, breastfeeding history and birth weight.
Intensive Six-Month Intervention
Children and their families attended hour-long intervention sessions monthly for six months. They were asked to fill out a survey about basic information such as level of physical activity and screen time. Children were measured for weight, height and waist circumference, and participated in a fitness shuttle run.
Children and their families met with the case manager to develop one or two main goals for the family that month (e.g. reduce the number of sugary drinks consumed). Case managers provided coaching and support to help the families meet their goals. Subsequently, the children were invited to participate in a nutrition program. Children were taught to make a healthy snack and were provided with the recipe for the snack. Parents had the opportunity to ask questions of the dietitians.
The evaluation of the project was a partnership between the public health unit, the community and academic institutions. Participant measurements (e.g. weight, height, physical fitness, eating habits) were taken prior to entry in the program and changes were tracked over a 12 month time period. Information on sociodemographics and food security was collected prior to entry in the program through in person interviews. Focus groups were also conducted to examine the utility of the training resource and the adaptability of the FIA model.
After the six-month intervention, the following improvements were noted:
(*Statistically significant P<0.05)
"There is a need to approach the issue of childhood obesity from a family perspective in order to have the greatest impact."
FIA Program Coordinator
A Families in Action Resource Manual was created with step-by-step instructions to introduce a culturally appropriate diabetes prevention program in the community. The manual is designed for use by community agencies that serve newcomers to communities or by those who are mandated to address diabetes prevention.
Download the complete manual and additional resources at
For additional information:
Gillian Mandich, Project Co-ordinator