Health behavior changes in Latino US-Mexico border residing adults participating in chronic disease preventive interventions

Abstract

Background: Non-communicable diseases are the leading cause of death among Mexican-origin adults. There is growing evidence for the effectiveness of community health worker led group interventions in lowering risk. This study aims to examine the behavioral and perceived health impacts of one such intervention tested in a US border community--Pasos Adelante, and contrasts those findings with those of its Northern Mexico adapted and delivered intervention, Meta Salud. The former is a Centers for Disease Control disseminated intervention based on its clinical impact, but little is known about which behavioral change objectives have been successfully addressed. Methods: The primary data comes from the largest cohort to date for evaluating Pasos (N =347); participants were recruited from community and clinical settings. Pasos was developed from a social cognitive theory-based intervention with extensive adaptations based on community participatory methods. Questionnaire data at baseline, conclusion of program, and at 6-month post program initiation were analyzed (e.g., generalized linear logistic mixed models). Findings: Pasos participants reported more physical activity (e.g., meeting CDC guidelines), healthier dietary choices and more positive perceived health at both post program assessments. Across both interventions, participants showed improved indicators of physical activity, whole milk consumption, sugary drink consumption, fruit consumption, mental health and self-rated health (ps<.05). Discussion: The findings suggest these interventions clinical improvements are likely to due to changes in many of the targeted health behaviors and psychosocial improvements. However there were less evidence for consistent changes in some behaviors (e.g., time sitting; vegetable consumption)--illustrating areas for strengthening these interventions.