Abuela to mother motivational interviewing intervention to reduce low-nutritive simple carbohydrate intake

Abstract

Background: Mexican-American children have the highest rates of childhood obesity of any ethnic group [1]. Because MexicanAmerican mothers follow the advice of abuelas (respected grandmothers in the Mexican-American community) more than that of health care providers [2], this pilot study evaluated the efficacy of using abuelas to deliver a motivational interviewing intervention to encourage Mexican-American mothers to limit their children's low-nutritive simple carbohydrate intake. Specific questions were whether or not 1) abuelas could deliver a motivational interviewing intervention, 2) abuelas could recruit and retain participants, and 3) mothers altered their attitudes/beliefs, perceived norms, perceived behavioral control (self-efficacy), intent and behavior of limiting their children's low-nutritive simple carbohydrate intake. Methods: Two abuelas were recruited and trained to deliver a motivational interviewing intervention. The abuelas recruited 6 mothers to participate in the study. Assessments and interventions occurred at baseline and 1 month. Attitude/beliefs, perceived norm and perceived behavioral control (self-efficacy) were measured using sub-scales of the Healthy Diet Survey [3], intent was measured using an Intent Questionnaire, and behavioral change was assessed using a short-form food frequency questionnaire. A Wilcoxon test (α=0.05) was used to evaluate changes in responses between baseline and 1 month. Results: The abuelas were successfully trained in motivational interviewing and reliably delivered the intervention. The abuelas recruited 6 mothers and all 6 participated through the entire study. All mothers felt it was important to limit their children's' low-nutritive simple carbohydrate intake (M=9.83, SD=.408) and scored their readiness to change as highly or extremely likely. Confidence in their ability to limit their children's low-nutritive simple carbohydrate intake increased (z=-2.041, p=.041) between baseline (M=6.33, SD=1.97) and 1 month (M=9.67, SD=.82) for 5 of the mothers. The sixth scored her confidence as 10 (the maximum) at both assessments. Responses to the food frequency questionnaire suggest a trend towards limiting their children's low-nutritive simple carbohydrate intake. Conclusions: This study demonstrated that recruitment, retention, and program delivery using abuelas were successful and the results suggest a trend towards mothers limiting their children's low-nutritive simple carbohydrates.

Evaluating Motivational Interviewing to Promote Breastfeeding by Rural Mexican-American Mothers: the Challenge of Attrition

“…In a current (ongoing) study (Joshi, Wilhelm, Aguirre, Trout, & Amadi, 2013), there has been no attrition largely because of the efforts of key team members who are familiar with the culture and communication patterns of this population as well as their persistence and flexibility in contacting the mothers. In a recent pilot study (Aguirre, Wilhelm, & Koehler, 2013), we successfully used abuelas to deliver a MI intervention to change mother's child feeding behaviors. In both studies, incentives (gift cards) are/were provided for each interaction with researchers.…”