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Soca Lozano S, Buro AW, Gonzalez-Videla K, Rodriguez C, Rancourt D, Gray HL, Bailey R, Redwine L, Stern M. Training Promotoras to Implement a Mindfulness-Based Healthy Lifestyle Program in Rural Communities. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:406-412. [PMID: 38520425 PMCID: PMC11162307 DOI: 10.1016/j.jneb.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/25/2024]
Abstract
Partnering with promotoras to implement a healthy lifestyle intervention has proven efficacious in reaching community members whom they serve. However, there are no clearly defined guidelines for implementing promotora training, especially when it involves developing mindfulness skills in promotoras unfamiliar with this concept. This is a report about the facilitators and barriers to training promotoras to implement a mindfulness-enhanced healthy eating and physical activity intervention, ADAPT+, using the Train-the-Trainer model. Following this model, we laid the foundations for sustained implementation of ADAPT+ even after the training process. Future studies may examine how these guidelines help map promotora training in other mindfulness-related interventions.
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Affiliation(s)
- Sandra Soca Lozano
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, FL
| | - Acadia W Buro
- College of Population Health, University of New Mexico, NM
| | - Karen Gonzalez-Videla
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL
| | | | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, FL
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL
| | | | - Laura Redwine
- Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, Tampa, FL
| | - Marilyn Stern
- College of Population Health, University of New Mexico, NM; Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL.
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Vahk A, Monsivais P, Johnson CM, Sharkey JR. An Evaluation of ¡Haz Espacio Para Papi!, a Culturally Tailored Nutrition and Physical Activity Pilot Program for Mexican-Heritage Fathers. Nutrients 2024; 16:1153. [PMID: 38674844 PMCID: PMC11053541 DOI: 10.3390/nu16081153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Fathers are potential leaders of healthy behavior changes in their families. Culturally tailored programs are needed to support behavior changes within families, including Latino families; however, there have been few father-focused nutrition programs for Latino families. This study evaluated the immediate effects of ¡Haz Espacio Para Papi! (Make Room for Daddy!; HEPP), a six-week, father-focused, family-centered program focused on nutrition and physical activity near the Texas-Mexico border. A modified stepped-wedge study design included a treatment group for the HEPP pilot and a wait-listed control group. Pre/post-tests included instant skin carotenoid scores, the self-reported dietary intake of fruits and vegetables (FV), and healthy dietary behavior scores (HDBSs). A 2 × 2 mixed analysis of variance evaluated changes in outcomes across time and between groups for 42 fathers with pre/post-test measures. There were no statistically significant changes in fathers' VM scores and FV intake across time or between groups. Fathers' HDBSs increased across time (p ≤ 0.01, 95% CI [0.23, 1.38]). Age, educational attainment, and the number of children living in the household did not have a significant effect on the program outcomes (p > 0.05). The HEPP program may guide the design of future father-focused nutrition interventions aimed at dietary behavior changes.
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Affiliation(s)
- Annika Vahk
- Nutrition and Exercise Physiology Program, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd., Spokane, WA 99202, USA;
| | - Pablo Monsivais
- Nutrition and Exercise Physiology Program, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd., Spokane, WA 99202, USA;
| | - Cassandra M. Johnson
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA;
| | - Joseph R. Sharkey
- School of Public Health, Texas A&M University, College Station, TX 77843, USA;
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Rodriguez Espinosa P, Vázquez E, AuYoung M, Zaldivar F, Cheney AM, Sorkin D, Zender R, Corchado CG, Burke NJ. Partnering With Community Health Workers to Address COVID-19 Health Inequities: Experiences of the California Alliance Against COVID-19. Am J Public Health 2024; 114:S45-S49. [PMID: 38207262 PMCID: PMC10785166 DOI: 10.2105/ajph.2023.307471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 01/13/2024]
Abstract
With funding from the National Institutes of Health's Community Engagement Alliance, starting in fall 2020, 11 academic medical centers and 75 community partners came together as the California Alliance Against COVID-19 to address COVID-19 inequities in California. Using data from focus groups, statewide meetings, and a statewide partner survey, we describe how promotoras and community health workers (P/CHWs; n = 540) helped to promote access to COVID-19 information, testing, and vaccination. We highlight opportunities to promote health equity among other public health collaborators with a P/CHW model. (Am J Public Health. 2024;114(S1):S45-S49. https://doi.org/10.2105/AJPH.2023.307471).
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Affiliation(s)
- Patricia Rodriguez Espinosa
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Evelyn Vázquez
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Mona AuYoung
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Frank Zaldivar
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Ann Marie Cheney
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Dara Sorkin
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Robynn Zender
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Claudia G Corchado
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
| | - Nancy J Burke
- Patricia Rodriguez Espinosa is with the Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA. Evelyn Vázquez and Ann Marie Cheney are with the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. Mona AuYoung is with the Department of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles. Frank Zaldivar, Dara Sorkin, and Robynn Zender are with the Institute for Clinical and Transnational Sciences, University of California, Irvine. Claudia G. Corchado is with Cultiva la Salud, United Way of Merced County, Merced, CA. Nancy J. Burke is with the Department of Public Health, University of California, Merced
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Johnson CM, Stubblefield E, Godinich BM, Walker M, Salcedo Price R, Allicock MA. A Scoping Review to Explore the Potential Benefits of Nutrition Interventions for Latino/a Adult Cancer Survivors in the US. Nutrients 2023; 15:4963. [PMID: 38068821 PMCID: PMC10708293 DOI: 10.3390/nu15234963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023] Open
Abstract
Despite evidence for the role of healthy diets in preventing cancer, little is known about how nutrition can support positive health outcomes after a cancer diagnosis for Latino/a cancer survivors in the United States (U.S.). The purpose of this scoping review is to understand the potential benefits of nutrition interventions in supporting healthy survivorship among Latino/a cancer survivors in the U.S. A team compiled, evaluated, and summarized the available evidence. Potentially relevant studies were identified from a comprehensive search of peer-reviewed databases and the gray literature. Eligible studies included Latino/a adult cancer survivors with a nutrition education, dietary change, or behavioral intervention; and a nutrition-related health outcome. Data were extracted and summarized using tables. The review included 10 randomized controlled trials, with samples or subsamples of Latino/a cancer survivors. Interventions mostly focused on breast cancer survivors. The results showed some evidence that dietary behaviors, like fruit and vegetable intake, were related to positive outcomes, like a decreased risk of cancer (through changes in DNA methylation), decreased risk breast cancer recurrence (through changes in inflammatory biomarkers), or improved perception of health status. The findings highlight a need for community-engaged and culturally relevant nutrition interventions for Latino/a adults, especially for rural communities; and innovative intervention approaches, including m/ehealth approaches with long-term follow-up.
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Affiliation(s)
- Cassandra M. Johnson
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA; (E.S.); (M.W.); (R.S.P.)
| | - Emily Stubblefield
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA; (E.S.); (M.W.); (R.S.P.)
| | - Brandon M. Godinich
- Center for Health Promotion and Prevention Research and Center for Pediatric Population Health, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 2777 North Stemmons Freeway, Dallas, TX 75207, USA; (B.M.G.); (M.A.A.)
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001 El Paso Ave, El Paso, TX 79905, USA
| | - Miranda Walker
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA; (E.S.); (M.W.); (R.S.P.)
| | - Ramona Salcedo Price
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA; (E.S.); (M.W.); (R.S.P.)
| | - Marlyn A. Allicock
- Center for Health Promotion and Prevention Research and Center for Pediatric Population Health, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 2777 North Stemmons Freeway, Dallas, TX 75207, USA; (B.M.G.); (M.A.A.)
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Rodriguez Espinosa P, Martinez Mulet Y, Chen WT, Kirk C, Tran C, Gonzalez M, Rosas LG. Community of Practice of Promotoras de Salud to address health inequities during and beyond the COVID-19 pandemic. Front Public Health 2023; 11:1260369. [PMID: 38026325 PMCID: PMC10679433 DOI: 10.3389/fpubh.2023.1260369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Using principles of Community-Based Participatory Research, we describe a community of practice for community health workers and promotoras (CHW/Ps) to address COVID-19 inequities in the Latinx community. We offer a concrete example of how programs can engage CHW/Ps as full partners in the research process, and how programs can support CHW/Ps' capacity and workforce development during implementation. We conducted four focus groups with CHW/Ps (n = 31) to understand needs and invited 15 participants to the community of practice to work on issues identified by the group. We examined impact according to number of community members reached, types of outreach activities, surveys, and online views of educational materials. Process evaluation involved two focus groups with seven organizations and a Ripple Effects Mapping session with the CHW/Ps. Our community of practice has built CHW/Ps' capacity via 31 workshop and co-created culturally and linguistically relevant COVID-19 materials that have reached over 40,000 community members and over 3 million people online. The community of practice proved effective in supporting CHW/Ps to address COVID-19 inequities in the Latinx community. Our evaluations demonstrated benefits for community-academic partnerships, for CHW/Ps, and for the community. This model represents an innovative workforce training model to address health inequities and can be applied to other health topics.
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Affiliation(s)
- Patricia Rodriguez Espinosa
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, United States
- Office of Community Engagement, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Yessica Martinez Mulet
- Office of Community Engagement, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Wei-ting Chen
- Office of Community Engagement, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Cary Kirk
- Office of Patient Experience, Stanford Health Care, Palo Alto, CA, United States
| | - Cindy Tran
- Office of Patient Experience, Stanford Health Care, Palo Alto, CA, United States
| | - Mike Gonzalez
- Santa Clara Family Health Plan, San José, CA, United States
| | - Lisa G. Rosas
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, United States
- Office of Community Engagement, Stanford University School of Medicine, Palo Alto, CA, United States
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Laviolette C, Johnson CM, Butler JL, Biediger-Friedman L, Sharkey JR. Nutrition Effects of a Family-Centered Health Promotion Program for Mexican-Heritage Children in the Lower Rio Grande Valley of Texas. Nutrients 2023; 15:nu15071600. [PMID: 37049438 PMCID: PMC10097021 DOI: 10.3390/nu15071600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Systemic and social factors, like poverty and food insecurity, negatively influence fruit and vegetable (FV) intake and body mass index (BMI) among Latino/a children. Behavioral programs are needed to support children’s nutrition. This study examined program effects on FV intake and BMI outcomes for Mexican-heritage children (9–11 years). The program used a modified stepped-wedge design in the Lower Rio Grande Valley of Texas (2019 and 2020). Promotoras led experiential nutrition education sessions and collected height, weight, and instant skin carotenoid scores (biomarker for FV intake) at pre-test (baseline), post-test (6 weeks), and maintenance (3–4 months after post-test). Mean changes and group differences in skin carotenoid scores, BMI z-scores and percentiles were obtained from analyses of variance. Linear mixed-effects models were used to determine overall program effects. Mexican-heritage children were enrolled (n = 57 and 52.6% female). An overall decrease in skin carotenoid scores was observed at post-test (−15.1; 95% CI: −24.95, −5.33). While scores varied widely (range: 17–498), an increase of 14.8 ± 23.8 points occurred in one intervention group. Compared to the control period, greater reductions in BMI outcomes occurred during the program. These findings provide evidence for the use of strengths-based approaches in behavioral nutrition programs.
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