RESUMO
INTRODUCTION: Hispanic populations are less likely that other ethnicities to meet physical activity guidelines. Community health worker (CHW) outreach is an effective delivery method for behavior change messages owing to shared culture, language, and life experience. This study examined the efficacy of a CHW-delivered intervention, Tu Salud ¡Si Cuenta! (Your Health Matters!) at Home Intervention, to promote physical activity among Mexican Americans. STUDY DESIGN: RCT. SETTING AND PARTICIPANTS: Mexican Americans living along the Texas-Mexico border from June 2010 to April 2013. INTERVENTION: Eligible adults were randomized into intervention (n=250) or standard care (n=250). Intervention participants received 6 monthly CHW visits that included education, motivation, and support for lifestyle changes. Standard care was potentially exposed to a community-wide health promotion campaign. Data were collected at baseline and 6- and 12-month follow-ups. MAIN OUTCOME MEASURES: Meeting physical activity guidelines was defined as ≥600 MET-adjusted minutes of moderate and vigorous exercise. RESULTS: Intervention participants were more likely to meet physical activity guidelines at 6 months (AOR=2.02, 95% CI=1.25, 3.26) than standard care, but the significance was not maintained at 12 months (AOR=1.53, 95% CI=0.92, 2.53). The results were similar in the as-treated and obesity-stratified analyses. The secondary analysis corroborated the primary results. CONCLUSIONS: This study shows increases in physical activity among those exposed to a CHW intervention, including participants with obesity. It also indicates that the removal of CHW contact tapers the effect at 12 months. TRIAL REGISTRATION: NCT01168765.
Assuntos
Agentes Comunitários de Saúde , Exercício Físico/fisiologia , Visita Domiciliar , Estilo de Vida , Americanos Mexicanos/estatística & dados numéricos , Educação de Pacientes como Assunto , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Texas , Adulto JovemRESUMO
OBJECTIVE: Examine relationships of healthy and unhealthy dietary patterns with BMI, sex, age and acculturation among Mexican Americans. DESIGN: Cross-sectional. Participants completed culturally tailored Healthy and Unhealthy Eating Indices. Multivariable mixed-effect Poisson regression models compared food pattern index scores and dietary intake of specific foods by BMI, sex, age and acculturation defined by language preference and generational status. SETTING: Participants recruited from the Cameron County Hispanic Cohort study, Texas-Mexico border region, between 2008 and 2011. SUBJECTS: Mexican-American males and females aged 18-97 years (n 1250). RESULTS: Participants were primarily female (55·3 %), overweight or obese (85·7 %), preferred Spanish language (68·0 %) and first-generation status (60·3 %). Among first-generation participants, bilingual participants were less likely to have a healthy eating pattern than preferred Spanish-speaking participants (rate ratio (RR)=0·79, P=0·0218). This association was also found in males (RR=0·81, P=0·0098). Preferred English-speaking females were less likely to consume healthy foods than preferred Spanish-speaking females (RR=0·84, P=0·0293). Among second-generation participants, preferred English-speaking participants were more likely to report a higher unhealthy eating pattern than preferred Spanish-speaking participants (RR=1·23, P=0·0114). Higher unhealthy eating patterns were also found in females who preferred English v. females who preferred Spanish (RR=1·23, P=0·0107) or were bilingual (RR=1·26, P=0·0159). Younger, male participants were more likely to have a higher unhealthy eating pattern. BMI and diabetes status were not significantly associated with healthy or unhealthy eating patterns. CONCLUSIONS: Acculturation, age, sex and education are associated with healthy and unhealthy dietary patterns. Nutrition interventions for Mexican Americans should tailor approaches by these characteristics.