Home Visit Intervention Promotes Lifestyle Changes: Results of an RCT in Mexican Americans.

INTRODUCTION

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.

STUDY DESIGN

RCT.

SETTING AND PARTICIPANTS

Mexican Americans living along the Texas-Mexico border from June 2010 to April 2013.

INTERVENTION

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.

RESULTS

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.

CONCLUSIONS

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.

TRIAL REGISTRATION

NCT01168765.