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What is Active & Healthy Families?

Active & Healthy Families (AHF) is a family-based group medical appointment program for children

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at risk for lifestyle-related conditions such as prediabetes, type 2 diabetes, and dyslipidemia.

Goal of the AHF Program

The AHF program is designed to provide Stage 1 (Prevention) and Stage 2 (Prevention Plus)

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care as described in The Expert Committee Recommendations Regarding the Prevention, Assessment and Treatment of Child and Adolescent Overweight and Obesity: Summary Report.

Program Content (6 Group Appointments and 6 Individual Monthly Appointments)

The AHF program consists of six-2 hour appointments every other week followed by

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six individual monthly appointments with the AHF team.

  Group Appointments Topics Covered
1. Healthy Habits Matter Benefits of practicing healthy habits daily
2. Eating for a Healthy and Strong Body Adequate serving for fruit and vegs, fast food, MyPlate method
3. Physical Activity and Screen Time Types of physical activity and daily recommendations, screen time limits
4. Managing Stress Stress reduction techniques, bullying
5. Cholesterol and Triglycerides Causes of high cholesterol and triglycerides and how to lower them
6. Review and Graduation Review of all topics covered

Individual monthly appointments for six months for participants who completed the program (attendance of at least six or all of the eight group appointments required).

Important Features of the AHF Program

  • Delivered by a Provider Triad (Physician/Nurse Practitioner, Registered Dietitian/Nutritionist, Community Health Worker)
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  • Culturally and linguistically tailored curriculum for Latino children and family
  • Interactive activities for children and parents included at each appointment
  • Individual time for child and parent with medical provider at each group appointment

Background of AHF Program

Response to High Prevalence of Obesity amongst youth in Contra Costa County

Latinos have the highest prevalence of obesity in Contra Costa County for youth

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age 2-19 years (PedNSS, 2010). Many Latinos face barriers maintaining good health, such as limited access to health insurance, cultural and linguistic factors, and socioeconomic and immigration status. In response to these barriers, the AHF program offers a curriculum tailored to the cultural and linguistic needs of Latino families.

First Prize Winner of the 2013 Childhood Obesity Challenge

The AHF program for Latinos was the first prize winner of the 3rd round obesity challenge sponsored by the American Journal of Preventive Medicine (AJPM)

Evaluation and Results of Randomized Controlled Study by University of California (Berkeley)

The AHF program for Latino Families was evaluated by the University of California in Berkeley during the fall of 2012 and spring of 2013 in a randomized controlled study. The study was funded by Safeway Foundation. Changes from baseline to post-intervention (10 weeks) in BMI, fasting blood sugar and blood lipids were compared between the intervention and the wait-list groups. The study took place in two Contra Costa County FQHCs. The participants were 40 Latino children age 5 to 12 years with a body mass index (BMI) of 85 percentile and above and their parents.

Results - Among the first 23 participants enrolled, there was a significant weight loss for the intervention group versus the control group (-0.5 lbs vs +2.0 lbs, p=0.012) and significant change in BMI (-0.6 kg/m vs+0.1 kg/m , p=0.004). There was a trend for differences in change in triglycerides (-14.8 vs +4.8, p=0.12) as well. Attendance to the AHF appointments among the intervention group was high, ranging from 82% to 98%.

The study was published in June, 2015 in Academic Pediatrics and was presented at the 8th Biennial Childhood Obesity Conference in San Diego, California.


The training site intends to provide all the materials and curriculum of the AHF program for providers planning to replicate it in their own clinic. The AHF team members’ script/talking points for each group appointment are also included in English and Spanish.

To ensure successful replication of the AHF group appointments program, it is strongly recommended to complete all the steps listed in the ACTIVITY CHECKLIST (below) before starting with the AHF Training website.

Please note that registration to create a Log In account is required for users of the AHF Training Site.


Daniela Jaramillo, MS, RDN
AHF Team Nutritionist


(Steps in the Replication of AHF Pediatric Overweight Group Appointment Program)

  STEPS Responsible Party Date Completed
1 Understand the program's goal All team members  
2 Get administration's support MD/NP  
3 Establish the AHF Triad:
  • Physician/Nurse Practitioner
  • Nutritionist (RD)
  • Community Health Worker/CMA
Requirements for Team Members:
  • Bilingual (English/Spanish)
  • Experience with Children
  • Training on Motivational Interviewing
MD/NP, Administration  
4 Address billing/reimbursements
(FQHC) fees for service; funding for materials, snacks in each appointment
5 Recruitment of at least 25 participants,
5-12 years with BMI>85%. Goal is 10-12 attendees at each appointment.
AHF Team  
6 Establish physician referral system for AHF eligible participants at least 3 months prior to start of program. AHF Team  
7 Identify a meeting place for the group appointments (location can accommodate up to 30 people which includes children and parents) Administration  
8 Preparation of the following: at least a month before start of program:
handouts, posters, forms, incentives and materials needed at each group appointment
9 Designate a third party- program Evaluator CHDP Nutritionist/Health Plan representative  

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Daniela Jaramillo, MS, RDN
Senior Public Health Nutritionist
Contra Costa Public Health Clinic Services