Promoting healthy nutrition in Mexican immigrant communities: results of the Secretos de la Buena Vida project.

CS19-01

A variety of nutrition interventions have targeted the Latino population, but little research has been conducted to determine the comparative efficacy and sustainability of these dietary behavior change methods among Latinos. In an attempt to inform the research, a randomized controlled trial, Secretos de la Buena Vida [Secrets of the Good Life], measured the 1-year impact of two dietary behavior-change interventions designed to reduce fat intake and increase consumption of dietary fiber among Mexican immigrant women. To accomplish this, a sample of 357 Spanish-dominant Latinas was recruited by random-digit-dialing to participate in a 14-week tailored nutrition communication intervention. Each woman was randomly assigned to one of the following three conditions: 1) tailored mailed print materials with personalized dietary counseling by lay health advisors (promotoras), 2) tailored mailed print materials only (tailored), and 3) targeted mailed "off-the-shelf" materials. Dietary data was collected at four different time points: baseline, 12 weeks (two weeks prior to the intervention conclusion), 6-months post-intervention, and finally, 12-months post-intervention. The initial analysis of the three groups in the immediate post-intervention period revealed significant improvements in the nutritional outcomes among the promotora group, as compared to the tailored and control groups. However, analyses of the follow-up periods indicate that the dietary achievements of the promotora group were no longer significant, while the tailored group continued to realize dietary improvements. The significant and relatively immediate improvements among the promotora group participants suggest that the personalized counseling and interpersonal interaction through home visits and phone calls served as significant behavioral reinforcement. In the short-term, the additional individual tailoring that may have occurred as a result of the relational dynamic made this intervention more effective when compared to the other two groups, but additional research is needed to determine if lasting behavioral effects can be achieved through intermittent follow-up counseling with promotoras.