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                  <mods:namePart>American Heart Association</mods:namePart>
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                  <mods:namePart>Unión Europea. Comisión Europea</mods:namePart>
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               <mods:identifier type="citation">J Am Coll Cardiol. 2020; 75(1):7-14</mods:identifier>
               <mods:identifier type="doi">10.1016/j.jacc.2019.10.021</mods:identifier>
               <mods:identifier type="e-issn">1558-3597</mods:identifier>
               <mods:identifier type="issn">0735-1097</mods:identifier>
               <mods:identifier type="journal">Journal of the American College of Cardiology</mods:identifier>
               <mods:identifier type="pubmedID">31726193</mods:identifier>
               <mods:identifier type="uri">http://hdl.handle.net/20.500.12105/8881</mods:identifier>
               <mods:abstract>BACKGROUND: The current trends of unhealthy lifestyle behaviors in underserved communities are disturbing. Thus, effective health promotion strategies constitute an unmet need. OBJECTIVES: The purpose of this study was to assess the impact of 2 different lifestyle interventions on parents/caregivers of children attending preschools in a socioeconomically disadvantaged community. METHODS: The FAMILIA (Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health) study is a cluster-randomized trial involving 15 Head Start preschools in Harlem, New York. Schools, and their children's parents/caregivers, were randomized 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 [FBS]), ranging from 0 to 15 (ideal health = 15). To assess the sustainability of the intervention, this study evaluated the change of FBS at 24 months. Main pre-specified secondary outcomes included changes in FBS subcomponents and the effect of the knowledge of presence of atherosclerosis as assessed by bilateral carotid/femoral vascular ultrasound. Mixed-effects models were used to test for intervention effects. RESULTS: A total of 635 parents/caregivers were enrolled: mean age 38 ± 11 years, 83% women, 57% Hispanic/Latino, 31% African American, and a baseline FBS of 9.3 ± 2.4 points. The mean within-group change in FBS from baseline to 12 months was ∼0.20 points in all groups, with no overall between-group differences. However, high-adherence participants to the intervention exhibited a greater change in FBS than their low-adherence counterparts: 0.30 points (95% confidence interval: 0.03 to 0.57; p = 0.027) versus 0.00 points (95% confidence interval: -0.43 to 0.43; p = 1.0), respectively. Furthermore, the knowledge by the participant of the presence of atherosclerosis significantly boosted the intervention effects. Similar results were sustained at 24 months. CONCLUSIONS: Although overall significant differences were not observed between intervention and control groups, the FAMILIA trial highlights that high adherence rates to lifestyle interventions may improve health outcomes. It also suggests a potential contributory role of the presentation of atherosclerosis pictures, providing helpful information to improve future lifestyle interventions in adults.</mods:abstract>
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                  <mods:topic>Caregivers</mods:topic>
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                  <mods:topic>Health promotion</mods:topic>
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               <mods:subject>
                  <mods:topic>Lifestyle</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Parents</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Vulnerable populations</mods:topic>
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                  <mods:title>Different Lifestyle Interventions in Adults From Underserved Communities: The FAMILIA Trial</mods:title>
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