Entertainment education and the promotora model are 2 evidence-based health communication strategies. This study examined their combined effect on promoting healthy eating among mothers in a family-based intervention. Participants were 361 Mexican-origin families living in Imperial County, California, who were randomly assigned to an intervention or delayed treatment condition. The intervention involved promotoras (community health workers) who delivered 11 home visits and 4 telephone calls. Home visits included a 12-minute episode of a 9-part situation comedy depicting a family struggling with making healthy eating choices; an accompanying family workbook was reviewed to build skills and left with the family. Baseline and immediate postintervention data were collected from the mothers, including the primary outcome of daily servings of fruits and vegetables. Other dietary and psychosocial factors related to healthy eating were examined. At postintervention, mothers in the intervention reported increases in daily vegetable servings (p ≤ .05); however, no changes were observed in fruit consumption. Improvements were observed in behavioral strategies to increase fiber (p ≤ .001) and to decrease fat intake (p ≤ .001), unhealthy eating behaviors (p ≤ .001), and individual (p ≤ .05) and family-related (p ≤ .01) perceived barriers to healthy eating. Entertainment education and promotoras engaged families and improved mothers' diets. Further research should examine the dose needed for greater changes.

Results reflect potentially higher medication nonadherence rates for Latinos with type 2 diabetes living in rural communities along the US-Mexico border. Additionally, this study supports the need to address strategies to support medication adherence, including addressing depression, for diabetes control. Strategies to promote adherence among Latino men are sorely needed, as are strategies to address forgetfulness and carelessness regarding diabetes medicine taking.

PURPOSE Peer support can promote diabetes control, yet research on feasible and effective peer support models is lacking. This randomized controlled trial tested a volunteer-based model of peer support for diabetes control.METHODS Thirty-four volunteer peer leaders were recruited and trained to provide support to 5 to 8 patients each through telephone contact, in-person, individual, and group support. Planned dose was 8 contacts, preferably in the first 6 months. Patients with uncontrolled diabetes were randomly sampled from the medical records of 3 community clinics. After a baseline interview and medical records review to obtain baseline values for the primary outcome, HbA 1c , 336 patient participants were randomly assigned to a 12-month peer support intervention or usual care. The assessment protocol was repeated at 6 and 12 months after baseline. RESULTSThirty peer leaders delivered an average of 4 contacts each per assigned participant (range 1-24). Despite the lack of intervention fidelity, the intervention was effective at reducing glycated hemoglobin (HbA 1c ) among intervention as compared with usual care participants (P=0.05). Similar trends were observed in frequency of meeting fruit and vegetable guidelines (P =0.09), a secondary outcome. Counterintuitively, usual care participants reported checking their feet more days out of 7 than intervention participants (P =0.03).CONCLUSIONS Given the modest changes we observed, combined with other evidence for peer support to promote diabetes control, additional research is needed on how to modify the system of care to increase the level of peer support delivered by volunteers.Ann Fam Med 2015;13(Suppl_1):S9-S17. doi: 10.1370/afm.1807. States (9.3% in 2012). 1 Rates are higher among Mexican-Americans (13.9%), among those who live near the US-Mexico border (14.7% on the US side, for instance) 2 and among residents of rural areas. INTRODUCTION D iabetes is prevalent in the United3 Health care use remains low in rural border communities, 4,5 and health care is underused for managing diabetes. 6,7 Research is needed on how to promote glycemic control in rural border communities.Controlling diabetes requires engaging in healthy behaviors such as exercise, self-monitoring, controlling symptoms, and using medication and health care properly. 8 An educator, potentially a peer leader, 9,10 can help persons with diabetes develop the necessary skills to make these behaviors part of their daily lives. In Latino and other racial/ethnic and low-income communities, community health workers (CHWs) often serve as educators and peer leaders, facilitating access to health care, training in selfmanagement behaviors, and providing emotional support. 9,[11][12][13][14][15][16][17][18][19] CHWs are typically members of the communities they serve and have direct or indirect experience with the health issue of interest.11 Most CHW interventions with Latinos to promote diabetes control have involved paid CHWs serving in various roles within a health care system or a community-...