Assessing Community Health Workers' effect on self-reported dietetic behaviors and constructs of two models of individual behavior
Heart disease is the leading cause of death among Hispanics in the U.S. Unhealthy diets are a modifiable risk factor for heart disease which can be improved with Community Health Worker (CHW) interventions. The first purpose of this study was to evaluate the effect of a CHW intervention using the Su Corazón, Su Vida curriculum on three self-reported dietetic behaviors, readiness for increasing fruit and vegetable intake and for reducing fat intake, and Health Belief Model (HBM) constructs related to heart health. The second purpose was to evaluate if HBM constructs and stages of change could predict changes in the self-reported dietetic behaviors. Methods. A total of 328 Hispanics were randomly assigned to a four-month CHW intervention or a control group. Self-reported dietetic behaviors (weight management, cholesterol and fat intake, and salt and sodium intake), readiness for increasing fruit and vegetable intake, and for decreasing fat intake, and HBM constructs (perceived susceptibility, perceived severity, perceived benefits, and self-efficacy) were collected at baseline and at post-intervention using a validated questionnaire. Chi-square, t-tests, and ANCOVA were used to compare changes in the variables of interest. Stepwise linear regression and ANCOVA were used to infer if the HBM constructs and the stages of change could predict changes in behavior. Results. Compared with the control group, the intervention group presented significantly higher post-intervention mean scores for all the three dietetic behaviors, and significantly lower post-intervention mean scores for all components of the HBM, with the exception of perceived severity, indicating that CHWs were effective in promoting positive changes in these variables. However, no difference in changes of stage was observed between the groups. Baseline self-efficacy, perceived severity, and perceived susceptibility predicted some, but not all, post-intervention mean scores for the scales measuring dietetic behaviors. Baseline readiness for increasing fruit and vegetable intake predicted only post-intervention mean scores for the Fat and Cholesterol Scale. Discussion. The results of this research can be used to support the integration of CHW programs into efforts aimed at promoting healthy eating conducive to heart health. The relationship of HBM constructs, stages of change, and self-reported dietetic behaviors among Mexican Americans requires further study.
Prado, Estelle Regina Dutra, "Assessing Community Health Workers' effect on self-reported dietetic behaviors and constructs of two models of individual behavior" (2008). ETD Collection for University of Texas, El Paso. AAI1458448.