Improving eating behavior through nutrition education for early prevention of obesity and type 2 diabetes in Hispanic communities

Obesity has become one of the main public health concerns worldwide. Children are also affected and are now facing obesity-related health conditions once primarily found in adults (e.g., type 2 diabetes and cardiovascular disease). Hispanic adults and children are among the populations at higher risk for obesity and its comorbidities. A data analysis comparing a study conducted in central México and the US National Health and Nutrition Examination Survey 2003-2004, revealed that residency (i.e., Mexican vs. Mexican-American and Caucasians) had a stronger influence than ethnicity (i.e., Mexican and Mexican-American vs. Caucasians) in terms of lipid profile and blood pressure, with children living in the US having less favorable levels. On the other hand, ethnicity was more related to less desirable dietary choices, with Mexican children presenting higher caloric and fat intakes. Hence, the need for strategies to prevent obesity and thus its comorbidities in highly at risk populations, like Hispanics, is imperative. Community-based interventions have proved effective and less expensive than clinic-based education among Caucasians. Dining with Diabetes, a community-based diabetes education program was modified to target the Hispanic community in Illinois. Comprised of 6 lessons and delivered in Spanish by community peer educators at University Extension offices, Comiendo con Diabetes aimed to improve blood glucose as well as knowledge and eating behavior for diabetes control. However, in spite of being effective at incresing knowledge related to diabetes control, process evalution highlighted several problems that limited feasibility and impact evaluation. Based on the formative evaluation of Comiendo con Diabetes, and as an attempt for early prevention of obesity among Hispanics, ¡SALUD! Comiendo en Familia, a nutrition education program to improve eating behavior of Hispanic adults with young children at home, was developed. Framed in Social Cognitive Theory, culturally tailored, and delivered in Spanish, the program consisted of 5 sessions of about 90 minutes each conducted at the Special Supplemental Nutrition Program for Women, Infants, and Children clinic in Champaign, IL. Sessions were designed to improve eating behavior by addressing knowledge, self-efficacy, outcome expectancies, and impediments through lecture, discussion, activities, and goal setting. An emotion-based approach was also incorporated. A questionnaire was developed and validated for content reflective of the culture and program content, and tested for internal reliability and stability. Both the program and questionnaire were content-validated by a panel of experts from around the country. Due to low recruitment response, a randomized control trial, originally proposed to test program impact, was withdrawn. A pilot study was conducted, instead, in order to test each individual session for relevance and appropriateness in the target audience. According to participants’ feedback, collected on post-session surveys and post-program focus groups, topics were relevant, sessions were attractive and culturally appropriate, and session components helped improve behaviors related to healthy eating. Given the higher risk for obesity and comorbidities that Hispanics bear, preventive interventions designed for this population are unquestionably necessary. However, factors adversely affecting Hispanics participation significantly decrease feasibility of such interventions. Hence, a better understanding of those participatory issues is necessary to approach this population more effectively.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Nutritional Sciences

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2013

Author dc:creator

• Diaz Rios, Lillian

Contributors dc:contributor

• Chapman-Novakofski, Karen M.
• Donovan, Sharon M.
• de Mejia, Elvira G.
• Teran-Garcia, Margarita D.

• Childhood obesity
• Nutrition education
• Program development
• Programevaluation
• Community-based intervention
• Obesity prevention

Statement dc:rights

• Copyright 2013 Lillian K. Diaz Rios

Language dc:language

en

Handle dc:identifier

http://hdl.handle.net/2142/45630

OAI identifier oai:identifier

oai:www.ideals.illinois.edu:2142/45630