Schmied Emily, Parada Humberto, Horton Lucy, Ibarra Leticia, Ayala Guadalupe
San Diego State University, San Diego, CA, USA Institute for Behavioral and Community Health, San Diego, CA, USA
University of North Carolina at Chapel Hill, NC, USA.
Health Educ Behav. 2015 Oct;42(5):583-92. doi: 10.1177/1090198115577375. Epub 2015 Mar 25.
Entre Familia: Reflejos de Salud was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker (promotora) model with an entertainment-education component. This process evaluation examined intervention implementation and assessed relationships between implementation factors and dietary change. Participants included 180 mothers randomized to an intervention condition. Process evaluation measures were obtained from participant interviews and promotora notes and included fidelity, dose delivered (i.e., minutes of promotora in-person contact with families, number of promotora home visits), and dose received (i.e., participant use of and satisfaction with intervention materials). Outcome variables included changes in vegetable intake and the use of behavioral strategies to increase dietary fiber and decrease dietary fat intake. Participant satisfaction was high, and fidelity was achieved; 87.5% of families received the planned number of promotora home visits. In the multivariable model, satisfaction with intervention materials predicted more frequent use of strategies to increase dietary fiber (p ≤ .01). Trends suggested that keeping families in the prescribed intervention timeline and obtaining support from other social network members through sharing of program materials may improve changes. Study findings elucidate the relationship between specific intervention processes and dietary changes.
《家庭内部：健康反射》是一项成功的基于家庭的随机对照试验，旨在改善美国拉丁裔家庭的饮食行为和摄入量，特别是水果和蔬菜的摄入量。新颖的干预设计将社区卫生工作者（推广员）模式与娱乐教育成分相结合。本过程评估考察了干预措施的实施情况，并评估了实施因素与饮食变化之间的关系。参与者包括180名被随机分配到干预组的母亲。过程评估指标来自参与者访谈和推广员记录，包括保真度、提供的剂量（即推广员与家庭面对面接触的分钟数、推广员家访次数）和接受的剂量（即参与者对干预材料的使用情况和满意度）。结果变量包括蔬菜摄入量的变化以及使用行为策略增加膳食纤维和减少膳食脂肪摄入量的情况。参与者满意度较高，且实现了保真度；87.5%的家庭接受了计划的推广员家访次数。在多变量模型中，对干预材料的满意度预示着更频繁地使用增加膳食纤维的策略（p≤0.01）。趋势表明，让家庭保持在规定的干预时间线内，并通过分享项目材料从其他社会网络成员那里获得支持，可能会改善变化情况。研究结果阐明了特定干预过程与饮食变化之间的关系。
