205609 Evaluation of dietary outcomes among pregnant Spanish-speaking Latina participants in Healthy Mothers on the Move (Healthy MOMS)

Monday, November 9, 2009

Edith Kieffer, MPH, PhD , School of Social Work, University of Michigan, Ann Arbor, MI
Kathleen B. Welch, MPH, MS , Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI
Erin Rees, MPH, PhD , School of Public Health, University of Michigan, Ann Arbor, MI
Emily Vogtmann, MPH , School of Public Health, University of Michigan, Ann Arbor, MI
Brandy Sinco, MS , School of Social Work, University of Michigan, Ann Arbor, MI
Christina Blumentritt, MPH, RD , Nutrition and Dietetics, Community Health and Social Services Center, Inc., Detroit, MI
Antonia M. Villarruel, PhD, RN , University of Michigan, Ann Arbor, MI
Virginia E. Uhley, PhD, RD , Department of Internal Medicine, University of Michigan, Ann Arbor, MI
Objective: To evaluate the influence of a community-based healthy lifestyle intervention on dietary behaviors associated with diabetes risk among pregnant Latinas in Detroit. Methods/Evaluation: The 11-week Healthy MOMS program, a randomized clinical study, provided individual and group social support, instruction and activities led by trained community Women's Health Advocates (WHA's). Food frequency questionnaires (FFQ) measured consumption of fruits, vegetables, fats, fiber and added sugars before and after the intervention. Mixed models analyses were conducted to estimate pre-and-post intervention changes within, and between, treatment (HLI) and control (HPE) groups, before and after adjustment for age, education, acculturation, healthcare site and parity. Results: Both baseline and follow-up FFQ's were completed by 217 women. In adjusted models at follow-up, HLI group women had reduced average daily consumption of added sugars, and total and saturated fat (by 19.2g, 15.8g, and 6.1g, respectively; all comparisons, p<.001). Daily vegetable consumption increased among HLI women by 0.3 daily servings (p<.01). Neither fruit nor fiber consumption within the HLI group varied significantly at follow-up compared to baseline. Among HPE women at follow-up, there were no significant changes in these dietary outcomes except a 2.1g decrease in daily fiber consumption (p<.05). Unadjusted models gave similar results for all outcomes. HLI group improvements were significantly greater than those for the HPE group for average daily consumption of added sugar (p<.03), and vegetables, total and saturated fat (p<.01) for all comparisons). Conclusion: A culturally tailored, community-based intervention by trained community health workers can help pregnant Latinas improve their dietary practices.

Learning Objectives:
1)Describe nutrition-related aspects of the Healthy MOMS program. 2)Describe fruit, vegetable, added sugar, fat and fiber consumption among Spanish-speaking Latinas before participating in the Healthy MOMS healthy lifestyle intervention for Spanish speaking Latinas. 3) Describe the influence of the Healthy MOMS intervention on change in fruit, vegetable, added sugar, fat and fiber consumption, before and after adjusting for healthcare and socio-demographic covariates. 4)Discuss future research and service implications of the findings.

Keywords: Pregnancy, Latinas

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Edith (Edie) Kieffer, MPH, PhD, is Associate Professor and Research Associate Professor in the University of Michigan, School of Social Work. Her career has focused on identifying, understanding and addressing environmental, social and behavioral correlates of maternal and child health, obesity and diabetes, emphasizing ethnic and geographic disparities. Dr. Kieffer is currently Principal Investigator of Healthy Mothers on the Move (NIH/NIDDK), Mothers Moving to a Healthy Future (HRSA/MCHB), Physical Activity Promotion Materials for Pregnant Latino and African American Women (NIH/NIDDK) and the Reach Detroit Partnership (CDC/Community Health and Social Services). These projects are developing, implementing, evaluating and disseminating practical family, social support, health care and community intervention strategies to promote healthy lifestyles and reduce the risk of obesity, diabetes and their complications. Dr. Kieffer is also analyzing data from three completed studies: Maternal Health and Pregnancy Outcomes among Hispanics (HRSA/MCHB) and Promoting Healthy Lifestyles Among Women (CDC) and Promoting Healthy Eating in Detroit (CDC). Dr. Kieffer provides consultation on diabetes and women’s health, health-related beliefs, behaviors, weight and diabetes during and after pregnancy, and community-based participatory research to local, state and national organizations. Dr. Kieffer is affiliated with the Michigan Diabetes Research and Training Center, the Detroit Community Academic Urban Research Center, the Center for Research on Ethnicity, Culture and Health and the W.K. Kellogg Community Health Scholars Program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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