Home Visit Intervention Promotes Lifestyle Changes: Results of an RCT in Mexican Americans
Am J Prev Med. 2019 Sep 27. pii: S0749-3797(19)30307-1. [Pubmed Abstract]
Vidoni ML, Lee M, Mitchell-Bennett L, Reininger BM
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.
Setting and Participants
Mexican Americans living along the Texas-Mexico border from June 2010 to April 2013.
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.
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.
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.