Tu Salud, ¡ Si Cuenta! : Exposure to a community-wide campaign and its associations with physical activity and fruit and vegetable consumption among individuals of Mexican descent

Abstract

Mexican Americans along the US-Mexico border have been found to be disproportionately affected by chronic diseases particularly related to lack of physical activity and healthful food choices. A community-wide campaign (CWC) is an evidence-based strategy to address these behaviors but with few examples of implementation in Mexican descent populations facing profound health disparities. We examined exposure to a CWC, titled Tu Salud ¡Sí Cuenta!, and its association with meeting the recommended minutes of moderate and vigorous physical activity weekly and consuming more portions of fruits and vegetables daily. A cross-sectional sample of 1438 Mexican descent participants was drawn from a city-wide, randomly-selected cohort interviewed between the years 2008 and 2012. Multivariable comparisons of participants exposed and not exposed to the CWC and meeting physical activity guidelines or their fruit and vegetable consumptions using mixed effects models were conducted. The community-wide campaign components included different forms of mass media and individually-focused components such as community health worker (CHW) home visits. After adjusting for gender, age, marital status, educational attainment, language preference, health insurance, and diabetes diagnosis, the strongest association was found between meeting physical activity guidelines and exposure to both CHW discussions and radio messages (adjusted OR=3.83; 95% CI= [1.28, 6.21]; p=0.0099). Participants who reported exposure to both radio and TV messages consumed more portions of fruits and vegetables than those who reported no exposure (adjusted RR=1.30; 95% CI= [1.02, 1.66]; p= 0.0338). This study provides insights into the implementation and behavioral outcomes associated with exposure to a community-wide campaign, a potential model for addressing lifestyle modifications in populations affected by health disparities.

Tu Salud ¡Sí Cuenta! Your Health Matters! A Community-wide Campaign in a Hispanic Border Community in Texas

“…The newsletters based on the Transtheoretical Model and Social Cognitive Theory included role model stories discussing coping techniques related to food choice, the pros and cons of selecting healthy foods and step-by-step guidance to make the healthy recipe of the month, among other behavioral change techniques previously reported. 25 This finding indicates that even within a community that may have been experiencing other policy and environmental changes related to nutrition effecting both those exposed and unexposed to TSSC, the TSSC components had an additional statistically significant, though small positive effect. This small effect is not unusual, as despite the theory-based behavioral techniques incorporated into the newsletter content, 25 this is a non-tailored, low intensity intervention component.…”

“…Details of the component implementation and timeline from 2005 to 2010 have been reported elsewhere. 25, 26 Briefly, TSSC is an intervention with multiple components, including TV and radio segments, newsletters, and home-based, individual and small-group discussions with community health workers (CHWs), to disseminate culturally and language-appropriate messages on physical activity and eating behaviors to a primarily Mexican-American population; the focus of this manuscript is on eating behaviors. The radio and TV segments, and the newsletters used behavioral change techniques from both Social Cognitive Theory 27 and Transtheoretical Model 28 , including instructions on healthy eating, pros and cons of healthy eating, and local, relatable role models talking about increasing their fruit and vegetable intake.…”

“…25 Participants were first asked to recall exposure to the campaign generally without the use of aids, then asked questions about the level of last 6-month exposure to specific TSSC components, regardless of their response to the first question. Exposure was confirmed by asking the participant to describe their favorite media message or their interaction with the CHW, using simple visual aids.…”

Meeting or Exceeding Physical Activity Guidelines is Associated with Reduced Risk for Cancer in Mexican-Americans

“…Physical activity in a typical week according to intensity, frequency (times/week) and duration (minutes/time) was assessed using the International Physical Activity Questionnaire short-form (IPAQ)[10] or the Godin Leisure-Time Exercise Questionnaire instruments [11] as reported previously [12]. The instruments have reported evidence of reliability and validity [10,13–16].…”

The Effects of a 12 Week Nutrition and Physical Activity Intervention Program on Mexican Americans Residing in the Lower Rio Grande Valley, TX

“…Another study conducted by Reininger et al, (2015), was done in a community along the U.S.-Mexico border. It was designed to increase fruit and vegetable consumption and physical activity in those individuals of Mexican descent.…”