期刊
出版社
MDPI
DOI: 10.3390/ijerph19084514
关键词
community-wide campaign; community health worker; physical activity; behavioral dietary intervention; built environment; implementation science; dissemination research; health behavior promotion; Latino community health; US-Mexico border health
资金
- UT Health Center for Clinical and Translational Science Award [UL1 TR003167]
- Texas Health and Human Services Commission SNAP-Ed program
- University of Texas Health Science Center at Houston School of Public Health Cancer Education and Career Development Program-National Cancer Institute/NIH [T32/CA057712]
This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (TSSC) to promote fruit and vegetable consumption and physical activity among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. The study found that TSSC had a positive impact on improving dietary habits and physical activity among participants, and the program was well-adopted and maintained in the communities.
This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud !Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC's reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into low exposure (2-3 visits) and high exposure (4-5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53-0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9-265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65-2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10-1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelity.
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