JMIR Publications

ABSTRACT

Background:

African-American youth (8 to 14 years old) do not adhere to national dietary and physical activity guidelines. Non-adherence to these recommendations contributes to disproportionate rates of obesity compared to their White counterparts. Culturally tailored e-health solutions are needed to communicate nutrition and physical activity messages that resonate with this target population.

Objective:

This study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African-American mother-child dyads.

Methods:

Statistical analysis included paired sample t-tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska’s Stages of Change towards the four behaviors: 1.fruit and vegetable selection on my plate; 2.meal preparation; 3. fruit and vegetable selection outside of home, and 4.physical activity were assessed with pre and post-test surveys. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes.

Results:

A final sample size of ninety-three mother-child dyads completed the study. Mothers reported significant improvement from pre-contemplation or contemplation stages to preparation or action stages for: 1) fruit and vegetable selection on her plate (p=.034); 2) meal preparation for her family (p=.010); 3) fruit and vegetable selection outside the home (p=.000); and, 4), and physical activity (p=.000). Significant improvements were found in knowledge, stage of change and self-efficacy for the four target behaviors of interest (p=.000). Children’s open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos.

Conclusions:

Culturally adapted cartoons that incorporate tailored preferences by African-American families, such as race or demography, may help increase adherence to target health behaviors when developing e-health behavior solutions.