Healthy Homes Healthy Families

The EPRC core research, funded by the CDC and guided by our Community Advisory Board in southwest Georgia, included the Healthy Rural Communities study, which qualitatively and quantitatively explored the relationships between diet, physical activity, and tobacco use across three settings (home, church, and worksite). This study informed the development and testing of a coach-based intervention to prevent weight gain among adults. The intervention, called Healthy Homes/Healthy Families, is an environmental change intervention. Coaches work with families to make changes in their home so that both their social and physical home environments are more supportive of healthy eating and physical activity.

After a pilot test of the intervention, our first Healthy Homes/Healthy Families randomized controlled trial began in early 2011 and was completed in the summer of 2013. Patients from three federally qualified health centers in southwest Georgia participated in the study. Those randomized to the intervention group were coached by staff trained by the EPRC and the Cancer Coalition of South Georgia (now named Horizons Community Solutions). The 5-month intervention was delivered through three home visits, four coaching calls, and four mailings of support materials. Coaches used two primary tools to guide families into creating healthier home environments: a Home Environment Profile, which is tailored to each home using baseline data, and a menu of Healthy Actions, which consists of strategies to make the home more supportive of healthy eating and physical activity. Participants randomized to the control group received three mailings of health education materials related to diet and physical activity. Data were collected via telephone interviews at baseline and at 6 and 12 months post baseline using a home environment survey, two 24 hour dietary recalls, a physical activity recall, and accelerometers.

We saw significant changes in the home food and activity environments and food-related behaviors of participants in the study. More recently, we completed an NCI-funded pilot and feasibility trial to adapt this intervention for telephone-based delivery with 2-1-1 clients in partnership with United Way of Greater Atlanta 2-1-1. The adapted intervention focused on the nutrition-related component of the original intervention and included six coaching calls and six text messages, delivered weekly, reducing the intervention from 16 weeks to 12 weeks.

Results from the pilot showed a significant increase in the Healthy Eating Index, decreases in kcals per day and self-reported weight, improvements in household food inventories, fewer family meals from non-home sources (e.g. less eating out), and more.