Implementing a family-based intervention to promote healthy family routines in deprived neighborhoods – a feasibility study from Bremen, Germany
Bibliographic record
Abstract
BACKGROUND: The prevalence of overweight and obesity among children in Europe is high. Particularly ethnic minority and low-income families are at increased risk. This highlights the need for effective family-based interventions addressing multiple obesity-related behaviors tailored to socially deprived families. Addressing this issue, our study aimed to adapt the North American ‘Healthy Habits, Happy Homes’ program to socially deprived neighborhoods in Bremen, Germany, and to test the feasibility of its implementation by using the RE-AIM model. METHODS: This single-arm intervention study was conducted between 2022 and 2023, including a process evaluation and a pre-post outcome assessment. Families with children aged 3–10 received 4 intervention visits from a health educator over a period of 3–9 months. The implementation fidelity was assessed via an intervention logbook. The acceptability and maintenance of intervention was assessed via feedback questionnaire filled out by parents and through qualitative data collected from parents, intervention staff and local stakeholders. The pre-post outcome assessment was conducted to evaluate its acceptability and to estimate changes in weight status of parents and children, and the children’s dietary habits, physical activity, sleep duration, screen time and behavioral problems. RESULTS: In total, 23 caregivers and 33 children participated in the intervention study, and 87% of the families reported at least one indicator of social deprivation. Recruitment proved to be challenging; active recruitment methods, i.e. approaching families personally, were more effective than passive ones. The program implementation demonstrated good fidelity and acceptability. Language barriers were perceived as obstacles in program delivery. 78% of the families completed the outcome measurement. Descriptive analysis revealed positive trends over time in increased physical activity, reduced screen time, and behavioral problems, but no changes in BMI, dietary habits, or sleep duration. Stakeholders recommended integrating the intervention into existing structures like kindergartens for long-term implementation. CONCLUSION: This study highlights the program’s acceptability and potential benefits for families in deprived neighborhoods of a German city, while acknowledging recruitment challenges. Further adaptations are needed to address barriers and integrate the intervention into wider community efforts to combat childhood obesity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".