High adherence rates to lifestyle interventions may improve health outcomes in underserved communities, according to results from the FAMILIA trial published Nov. 11 in the Journal of the American College of Cardiology, which will be presented at AHA 2019 in Philadelphia, PA.

Rodrigo Fernandez-Jimenez, MD, PhD, et al., randomized 15 Head Start preschools in Harlem, NY, as well as their children's parents or caregivers, to receive either an "individual-focused" or "peer-to-peer based" lifestyle intervention program for 12 months or control. The primary outcome was the change from baseline to 12 months in a composite health score related to blood pressure, exercise, weight, alimentation and tobacco (Fuster-BEWAT Score).

Results showed that out of the 635 parents or caregivers enrolled in the study, there were no differences in the change of the non-laboratory based Fuster-BEWAT Score between control and intervention arms neither at 12 months nor at 24 months. However, high-adherence participants to the intervention exhibited a greater change in Fuster-BEWAT Score than their low-adherence counterparts, indicating that intervention adherence is critical to achieving a potential beneficial impact.

Furthermore, the authors found that the identification and understanding of ultrasound-based images of atherosclerosis by the participant consistently boosted the intervention effects. They also identified subgroups of participants that showed lifestyle interventions could have a greater impact, which may be useful to tailor future health promotion programs in adults.

"The interventions applied to caretakers are easy to implement, and results show if adults follow and stick to simple education plans they may see positive results and reduce their risk factors for developing heart disease throughout their lives," explains Valentin Fuster, MD, PhD, MACC, who created and led the trial. "The FAMILIA project has already shown that early interventional health education is effective for preschoolers and the new results for caretakers further prove low-cost methods can promote health among parents and school staff. We hope in time we can integrate this project into schools across the country to help more families, especially those in underserved communities."

"A wider adoption of effective health promotion programs at the population level may have a meaningful impact on the reduction of health disparities and cardiovascular disease burden," the authors add.

Keywords: AHA Annual Scientific Sessions, AHA19, Child, Preschool, Tobacco, Risk Factors, Blood Pressure, Caregivers, Life Style, Health Promotion, Early Intervention, Educational, Body Weight, Cardiovascular Diseases, Atherosclerosis

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