Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in postpartum Latinas.
Methods
Madres para la Salud [Mothers for Health] was a 12-month, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity (PA) seeking to effect changes in body fat, fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This report describes the efficacy of the Madres intervention.
Results
The results show that while social support increased during the active intervention delivery, it declined to pre-intervention levels by the end of the intervention. There were significant achievements in aerobic and total steps across the 12 months of the intervention, and declines in body adiposity assessed with bioelectric impedance.
Conclusions
Social support from family and friends mediated increases in aerobic PA resulting in decrease in percent body fat.
Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes.
Methods
Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance.
Discussion
The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth.
This project aimed to identify barriers to participation and develop strategies to increase the accessibility of a diabetes prevention program in the Latino community. Surveys were administered to past participants of a randomized control trial at a community event where study results were shared. The top concerns expressed by respondents were related to the use of personal information. Primary barriers to participation included work/school commitments and transportation issues. Strategies to increase accessibility included providing flexible class times, having bilingual research staff, and using multiple forms of community outreach such as flyers, health events, phone calls, texts, and social media. Expanding community partners was also identified as a primary strategy for increasing program reach. Researchers should focus on addressing confidentiality concerns, providing financial compensation for attendance, flexible scheduling, and utilizing diverse outreach methods to enhance access to diabetes prevention programs in the Latino community
Background: There is limited literature evaluating the impact of disseminating research results to past research study participants and their families. The purpose of the study was to evaluate whether disseminating results from a diabetes prevention program to past participants and their families facilitates motivation to engage in healthier behaviors. Methods: Previous youth participants from the “Every Little Step Counts” study were contacted and invited to a community dissemination event in November of 2022 at a local YMCA in the Phoenix Metropolitan area. All individuals in attendance at the event were invited to complete a 10-item questionnaire following a presentation about diabetes and the study results. 10 youth past participants, 9 adult past participants, and 13 community members completed the questionnaire to assess whether dissemination of past study results increases motivation to engage in healthier behaviors. Results: Aggregate responses revealed a 28.43% increase in motivation to eat healthier and a 33.45% increase in motivation to increase exercise. An increase in average response frequency was evident amongst all figures, indicating that overall, dissemination of research results was found to increase motivation to engage in healthier behaviors across community members, adult participants, and youth participants. Conclusions: This study supports the importance of disseminating research results from a diabetes prevention program to past participants in order to reinforce and maintain behavior change skills taught throughout the study, with the long-term goal of reducing type 2 diabetes risk in youth.
Background: Low physical activity (PA) and fruit and vegetable (F&V) consumption in early childhood are continued public health challenges. This manuscript describes outcomes from two pilot studies for Sustainability via Active Garden Education (SAGE), a program designed to increase PA and F&V consumption among 3 to 5 year old children.
Methods: SAGE was developed using community-based participatory research (CBPR) and delivered to children (N = 89) in early care and education centers (ECEC, N = 6) in two US cities. Children participated in 12 one-hour sessions that included songs, games, and interactive learning activities involving garden maintenance and taste tests. We evaluated reach, efficacy, adoption, implementation, and potential for maintenance of SAGE following the RE-AIM framework. Reach was evaluated by comparing demographic characteristics among SAGE participants and residents of target geographic areas. Efficacy was evaluated with accelerometer-measured PA, F&V consumption, and eating in the absence of hunger among children, parenting practices regarding PA, and home availability of F&V. Adoption was evaluated by the number of ECEC that participated relative to the number of ECEC that were recruited. Implementation was evaluated by completion rates of planned SAGE lessons and activities, and potential for maintenance was evaluated with a parent satisfaction survey.
Results: SAGE reached ECEC in neighborhoods representing a wide range of socioeconomic status, with participants’ sociodemographic characteristics representing those of the intervention areas. Children significantly increased PA during SAGE lessons compared to usual lessons, but they also consumed more calories in the absence of hunger in post- vs. pre-intervention tests (both p < .05). Parent reports did not suggest changes in F&V consumption, parenting PA practices, or home F&V availability, possibly due to low parent engagement. ECEC had moderate-to-high implementation of SAGE lessons and curriculum. Potential for maintenance was strong, with parents rating SAGE favorably and reporting increases in knowledge about PA and nutrition guidelines for young children.
Conclusions: SAGE successfully translated national PA guidelines to practice for young children but was less successful with nutrition guidelines. High adoption and implementation and favorable parent reports suggest high potential for program sustainability. Further work to engage parents and families of young children in ECEC-based PA and nutrition programming is needed.