The prevalence of obesity has more than tripled for children aged 6-11 years over the past three decades, especially among Mexican-Americans. Promising interventions have involved promotion of more vigorous physical activity and have included the child's family in the intervention. In this proposal, we will focus on activity change in Latino elementary school-aged children (3rd-5th grade) who are at-risk for overweight (body mass index [BMI] equal to or more than 85% and less than 95%) or obese (equal to or more than 95% BMI). Child-parent pairs will be encouraged to increase their physical activity, with the primary provider's office as a conduit to regular use of a community recreation center (a local YWCA) over a period of six months. The first """"""""On the Move"""""""" clinic will combine: individual and group counseling for child-parent pairs; collocation of an activity van at the clinic site; and the development of a child-parent activity contract. The subsequent five monthly visits will occur within the YWCA. The YWCA will function as an extension of the provider's office, reinforcing children's health through activity and group discussion sessions, monitoring BMI and blood pressure (BP), and communicating to the primary provider's office. The intervention group will be compared to a control group of Latino children matched for age and BMI category (obese or at risk for overweight). The control group will receive baseline counseling on the importance of regular physical activity in a group setting at the primary provider's office, with a follow-up BMI and BP check 6 months and one year later. Both groups will receive a free YWCA family membership at the time of study enrollment to increase access to a centrally located recreation center. Active collaborations between the provider's office and community recreation centers have the potential to slow the rise of obesity, and tip the energy balance in favor of stabilizing and ultimately decreasing BMIs. This study functions as an exploratory study; we plan to examine feasibility of the proposed process, and evaluate promising intermediate outcomes, including self-reported activity, self-efficacy, and use of a community recreation center. As a measure of adiposity, we will measure BMI at three points in time for both groups. The results could be important from a preventive perspective and are especially needed in our state, which has the fastest-growing Latino population in the U.S.
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