Evaluation of health educator consults in primary care

Purpose: The paper aims to evaluate a primary care obesity prevention intervention, targeting low-income minority parents in the USA. The first objective is to describe the barriers to behavior change experienced by families. The second objective is to understand the types of strategies that were used by the health educator to empower families to engage in healthy behavior changes. Design/methodology/approach: Qualitative methods were used to conduct a content analysis of the intervention's instruments and health educator's notes on counseling sessions. Demographic data were collected from the patient information system. Findings: Households were 80 percent Hispanic and 17 percent African American. A total of 26 percent of the children were overweight or obese. Themes identified were poor parenting skills, which included sub themes of picky eating, food-related tantrums, bottle feeding, and submitting to unhealthy food requests; poor knowledge and skills regarding healthy eating; and psycho/social issues acting as barriers to healthy eating, including sub themes of housing issues, parental unemployment and intergenerational conflict regarding food choices. Originality/value: There are few family-based obesity prevention interventions, especially in low-income minority communities. This study found that parents are interested in improving the intake of healthy foods for their families; however, they face substantial barriers. This study supports enhanced health assessment as part of the preschool preventive visit. The authors also found that a skilled, culturally competent, health educator is essential to extend counseling beyond the brief encounter with physicians, as well as advocacy for systematic and policy level changes, to address the complex context in which behavior change can occur.