Healthy immigrant families: Participatory development and baseline characteristics of a community-based physical activity and nutrition intervention.

Jane W Njeru, Irene G Sia, Julie A Nigon, Abdullah Hared, Ahmed Osman, Maria Graciela D Porraz Capetillo, Miriam Goodson, James A Levine, Adeline Abbenyi, Mark L Wieland, Paul J Novotny, Jeff A Sloan, Matthew M Clark, Christi A Patten, Sonja J Meiers, Marcelo M K Hanza, Jennifer A Weis

Journal: Contemporary clinical trials 2017;47():22-31

PMID: 26655431

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Abstract

BACKGROUND

US immigrants often have escalating cardiovascular risk. Barriers to optimal physical activity and diet have a significant role in this risk accumulation.

METHODS

We developed a physical activity and nutrition intervention with immigrant and refugee families through a community-based participatory research approach. Work groups of community members and health scientists developed an intervention manual with 12 content modules that were based on social-learning theory. Family health promoters from the participating communities (Hispanic, Somali, Sudanese) were trained to deliver the intervention through 12 home visits during the first 6 months and up to 12 phone calls during the second 6 months. The intervention was tested through a randomized community-based trial with a delayed-intervention control group, with measurements at baseline, 6, 12, and 24 months. Primary measurements included accelerometer-based assessment of physical activity and 24-hour dietary recall. Secondary measures included biometrics and theory-based instruments.

RESULTS

One hundred fifty-one individuals (81 adolescents, 70 adults; 44 families) were randomized. At baseline, mean (SD) time spent in moderate-to-vigorous physical activity was 64.7 (30.2) minutes/day for adolescents and 43.1 (35.4) minutes/day for adults. Moderate dietary quality was observed in both age groups. Biometric measures showed that 45.7% of adolescents and 80.0% of adults were overweight or obese. Moderate levels of self-efficacy and social support were reported for physical activity and nutrition.

DISCUSSION

Processes and products from this program are relevant to other communities aiming to reduce cardiovascular risk and negative health behaviors among immigrants and refugees.

TRIAL REGISTRATION

This trial was registered at Clinicaltrials.gov (NCT01952808).

Address: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States. Electronic address: [email protected].; Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, United States.; Department of Research Administration, Mayo Clinic, Rochester, Minnesota, United States.; Department of Nursing, Winona State University, Rochester, Minnesota, United States.; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, United States.; Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States.; Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.; Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, United States.; Division of Endocrinology, Mayo Clinic, Scottsdale, Arizona, United States.; Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, Minnesota, United States.; Language Services, Mayo Clinic, Rochester, Minnesota, United States.; Somali Community Resettlement Services, Rochester, Minnesota, United States.; Hawthorne Education Center, Rochester, Minnesota, United States.; Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States.

DOI: 10.1016/j.cct.2015.12.004

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MeSH Terms: Adolescent, Adult, Child, Community-Based Participatory Research, Diet, Healthy, Emigrants and Immigrants, Exercise, Family, Family Health, Female, Focus Groups, Health Promotion, Healthy Lifestyle, Hispanic or Latino, Humans, Male, Middle Aged, Minnesota, Obesity, Overweight, Refugees, Self Efficacy, Social Learning, Somalia, Sudan