Health Without Barriers-Larimer County: Planning and Implementation of a Family-inclusive Lifestyle Intervention for Mental Health Promotion and Cardiometabolic Disease Prevention

College of Health and Human Sciences

Human Development & Family Studies

Larimer 

County 

(Weld)

Primary Topic:

FCS, Nutrition, & Food Safety

Other Topics:

4-H & Youth, Health & Wellbeing, DEI

Lead Mentor:  

Lauren Shomaker

Associate Professor

Internship Overview:

The proposed internship will be within the scope of two, community-based and inter-related projects: (1) “Mental Health Interventions in At-Risk Adolescents,” and (2) “Family Inclusive Childhood Obesity Treatment Designed for Low-Income and Hispanic Families.” In the first project, we have been delivering an empirically-supported mindfulness-based group intervention to Larimer County community-area adolescents. The program we have been implementing is called Learning to BREATHE, which is an adolescent adaptation of mindfulness-based stress reduction. We, and others, have shown that Learning to BREATHE reduces depression symptoms and improves mindfulness and emotion regulation, as well as offering potential benefits for health-related outcomes like eating behavior and indicators of cardiometabolic health. To date, as part of the current project, we have delivered Learning to BREATHE to nearly 60 adolescents ages 12-18 years. Delivery in this iteration hinges on partnerships with Larimer community area stakeholders, including the Family Center (La Familia), the Fort Collins Senior Center, the Kendall Anderson Nutrition Center, and within the last few months, Larimer County Extension. We are thrilled to engage with Extension to outreach to their networks serving youth who may benefit from mindfulness training. Whereas this first project has been focused on program delivery to groups of adolescents, the second project embeds youth mindfulness training in a whole-family inclusive lifestyle intervention for youth and families called Health Without Barriers. This whole-family inclusive lifestyle program includes Learning to BREATHE for adolescents, PLUS cooking classes for the family, parent nutrition and parenting education, and physical activity for youth. Partnering with Matthew Haemer, MD, MS, a pediatrician with expertise in community-based treatment of obesity, our group is responsible for implementation of Health Without Barriers in Northern Colorado. We are excited to leverage our budding relationship with Larimer County Extension to plan and deliver components of Health Without Barriers in Larimer County in partnership with Extension. In particular, our immediate goals are delivery of the Cooking Matters curriculum to Larimer County resident families, in conjunction with adolescents who received – or will receive – Learning to BREATHE. We are measuring both quantitative and qualitative indicators of feasibility, acceptability, and health benefits and will use this information as pilot data to apply for a grant application to further expand the work in Larimer County.

Collectively, we have worked with many graduate and undergraduate students, including summer program students (e.g., National Science Foundation Bench-to-Baccalaureate program), as well as students from minoritized backgrounds (e.g., National Institutes of Health Diversity Supplements, American Psychological Association/National Institutes of Health LEAP mentor program for Diverse Scholars, etc.). We have not yet participated in the Summer Extension Internship program. Yet, we are excited to submit this application to that end. With a strong engaged scholarship program in place, an eager team, and a well thought out plan for individualized professional development for a Summer Intern, we are delighted to incorporate an intern on mindfulness and cooking programming for adolescents and their families in Larimer County.

Goals, Scope and Objectives:

The proposed internship is called “Health Without Barriers-Larimer County: Planning and Implementation of a Family-inclusive Lifestyle Intervention for Mental Health Promotion and Cardiometabolic Disease Prevention.” The *overall goal* is to plan and implement one six-week Health Without Barriers family cooking intervention to Larimer County residents. The *specific objectives* are to (1) plan program implementation, (2) enroll ~8-10 families, and (3) evaluate feasibility, acceptability, and perceived health benefits of the program to stakeholders. Completion of these objectives will result in attainment of critical preliminary data to inform a competitive grant application to support the infrastructure needed to implement the complete Health Without Barriers program in Larimer County as an Extension-Colorado State University field/campus partnership.

*Scope*: Objective 1 will involve engagement of relevant stakeholders to select a program delivery location (e.g., North Azatlan Senior Center, Fort Collins Senior Center), identify/train facilitators in the family cooking manualized curriculum, design/update recruitment/marketing materials, and obtain institutional review board approval (or exemption), as indicated. Objective 2 will involve engagement of stakeholders to distribute recruitment materials and enroll families. Objective 3 will include collection of surveys, administration of interviews, and compilation of quantitative-qualitative data to assess feasibility, acceptability, and perceived health benefits to participating adolescents and parents/caregivers.

Based upon our experiences delivering the multi-component Health Without Barriers program in other settings, we feel confident the goals, objectives, and scope of the proposed internship focused on the family cooking portion will be feasible and that the outcomes are likely to yield a feasible/acceptable program to Larimer County residents.

With which stakeholder group(s) will the intern work?

The intern will work with the team of mentors (Shomaker, Webb, Sanchez, Moran) to outreach to Larimer County organizations with whom we already have existing relationships in various stages/capacities and all of whom serve youth and families in Larimer County. Examples include the Poudre River Public Library District, the Family Center/La Familia, Salud Family Health Center, UC Health, the Poudre School District, the Public Health Department, Boys and Girls Club, the Senior Center, the Kendall Anderson Nutrition Center, Summit Stone, Cooking Matters, and the Azatlan Community Center. The intern also will engage with the Larimer County Extension office (with mentorship from Ms. Webb), the Human Development and Family Studies/College of Health and Human Sciences and Colorado School of Public Health (with mentorship from Dr. Shomaker, Ms. Sanchez, and Ms. Moran), and the community advisory board that supports the community-engaged work of Dr. Shomaker’s research team in Fort Collins/Northern Colorado.

These networks will be used to plan, recruit, implement, and evaluate a six-week family cooking program in Larimer County.

What student learning outcomes do you anticipate and what are the opportunities for professional development?

We will work with the intern to establish an individualized learning plan, which aligns learning outcomes to the trainee’s individual needs/preferences/career goals. We anticipate learning outcomes will include: (a) increased knowledge of empirically-supported community food/nutrition/health interventions, (b) enhanced knowledge of Larimer County stakeholders/networks invested in nutrition/health/wellness, (c) skill acquisition of strategies/methods for community/stakeholder engagement, (d) learning skills for effective partnership building centered in community-based participatory research and engaged scholarship principles, and (e) increased knowledge of community-based program evaluation/grant preparation. Depending upon the intern’s individualized interests, they might consider gaining skills in program facilitation or particular facets of dissemination and/or analysis.

The intern’s summer learning plan will be complemented by a host of professional development opportunities. Dr. Shomaker’s team includes 5 psychologists, a postdoctoral fellow, 7 full-time professional staff, 4 MPH students, and 3 doctoral students, with collaborators in medicine, pediatrics, nutrition, exercise science, psychiatry, public health, etc. Larimer County Extension is a long-standing, strong unit with nearly 20 professionals who offer an array of expertise relevant to community health, wellness, and youth/families. Its proximity to main campus makes for a convenient partnership to co-conduct programs/program evaluation and offer a rich training environment that bridges campus-field engagement. In addition to individual weekly meetings with Dr. Shomaker and biweekly mentor meetings with Ms. Webb, the intern will choose from ample professional development activities available as part of main campus, our lab, Extension, local community/hospitals, etc. Students will disseminate findings as part of the intern program in addition to dissemination directly to stakeholders.
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