RAISE Families for Health: A pilot hybrid effectiveness-implementation evaluation of a parent-focused multiple health behavior change intervention in an integrated care clinic
This pilot hybrid Type I study demonstrates that the RAISE Families for Health intervention, a theory-driven, parent-focused multiple health behavior change program delivered virtually in an integrated care clinic, is feasible and acceptable while showing preliminary effectiveness in improving sleep duration, perceived food quality, and health confidence among underserved Hispanic/Latine families.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Chronic diseases like heart disease, diabetes, and high blood pressure are the leading causes of death and disability in the United States. While these conditions have many causes, they are strongly linked to daily habits: what people eat, how much they move, whether they smoke, and how well they sleep. These habits often cluster together; for instance, poor sleep can drain the energy needed for exercise, and stress can lead to unhealthy eating. These patterns are not just individual choices; they are often passed down from parents to children, creating a cycle of health risks that is hard to break. Families, particularly those facing financial hardship, bear a disproportionate burden of these risks. To stop this cycle, health experts have long believed that helping parents improve their own habits is one of the most powerful ways to protect their children's future health. However, designing programs that successfully change multiple habits at once for busy parents, especially within the real-world setting of a community clinic, remains a difficult challenge.
A team of researchers set out to test a new approach called RAISE Families for Health, designed specifically for parents and caregivers in an integrated care clinic in Denver, Colorado. This clinic serves a community where many families are Hispanic or Latino and face significant economic challenges. The program was built on a simple but powerful idea: to change behavior, a person needs three things. First, they need accurate information about what is healthy. Second, they need the motivation to want to change. Third, and perhaps most importantly, they need the practical skills to make those changes stick in their daily lives. The researchers wanted to see if a program teaching these three elements could help parents sleep better, eat healthier, move more, and manage stress, all while fitting into the chaotic schedules of real families.
The study took place during a time of great disruption, as the program launched just as the COVID-19 pandemic forced clinics to close their doors to in-person visits. This meant the entire eight-week curriculum, which was originally planned to be held in person, had to be delivered virtually over a video platform. Despite this sudden shift, the program reached 65 parents, all of whom were women, and the majority of whom identified as Hispanic or Latino. The virtual format turned out to be a surprising advantage for many participants. Instead of worrying about finding childcare or driving to a clinic after work, mothers could join the sessions from their living rooms, sometimes with their children nearby. This flexibility allowed the program to reach people who might otherwise have been unable to attend.
Over the course of the program, the parents reported meaningful changes in their lives. The most significant improvements were seen in sleep and diet. On average, participants increased their nightly sleep from about 6.9 hours to 7.4 hours. While this might seem like a small number, for a population where nearly 60 percent were not getting the recommended amount of rest, it represented a substantial shift toward better health. Participants also rated the quality of their family's food higher, moving from an average of 6.2 to 7.1 on a ten-point scale. They felt more confident in their ability to improve their family's health, a crucial step in making lasting changes. Even among the few parents who used tobacco, the program seemed to help; one person quit completely, and others reduced their use or started using nicotine replacement therapy.
The researchers also looked at whether the program worked differently for different groups of people. They found that the benefits were shared across the board. The program reached Hispanic and Latino parents at the same rate as non-Hispanic parents, and it was effective for those with lower incomes just as much as for those with slightly higher resources. This suggests that the approach was not dependent on a specific background or economic status to work. The parents themselves described the experience as supportive and empowering. They spoke about the value of connecting with other mothers who faced similar struggles, noting that they no longer felt alone in their efforts to be healthier. The facilitators, who were clinic staff trained to guide the sessions, were praised for creating a trusting and compassionate environment.
While the study showed clear progress in sleep, diet, and confidence, it also highlighted areas where change is harder to achieve. The program did not produce statistically significant increases in physical activity or reductions in perceived stress, although the numbers did move in the right direction. The researchers suspect that changing how much one moves or managing deep-seated stress might require more time, resources, or different strategies than improving sleep or food choices. It is also possible that the parents were already so motivated to help their families that their initial scores were already very high, leaving little room for improvement to be measured. The study was a pilot, meaning it was a smaller test run rather than a massive, final experiment, so the researchers cannot yet say with absolute certainty that the program caused every single change observed. However, the results are promising enough to suggest that this type of family-focused, multi-habit program is feasible and effective enough to be tested on a larger scale.
The success of RAISE Families for Health offers a hopeful glimpse into how public health interventions can adapt to real-world constraints. By meeting parents where they are—both in their homes and in their lives—the program managed to break through barriers that often keep families from accessing health resources. The findings suggest that when parents are given the right mix of knowledge, encouragement, and practical skills, they can make positive changes that ripple through their entire families. As the researchers move forward, they plan to refine the program and test it with more people, including fathers, to see if these benefits can be sustained and expanded to even more communities. For now, the study stands as proof that even in the face of a global pandemic, it is possible to build a bridge to better health for underserved families.
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