Using book clubs to model healthy eating and physical activity in a low-income population: Results from the Be Well book pilot study

The Be Well Book is a collection of role model stories from diverse American mothers about improving the health of their families through better nutrition and physical activity (PA). We hypothesized that reviewing the book in a group “book club” setting could motivate low-income mothers to make healthy changes in their lifestyles via peer-modeling. METHODS A multi-method pilot study was conducted to determine the effect of reading the book on parents' behavior, intentions, knowledge and self-efficacy for nutrition and PA. Parents (n=54) of children in low-income elementary schools in Austin, Texas were recruited through schools. Control parents (n=33) received the book with instructions to read it independently; the intervention group (n=21) participated in a four-session moderated “book club”. Surveys were administered pre and post intervention; all subjects also participated in focus groups post-intervention. RESULTS Subjects were largely Hispanic (94%), and Spanish-speaking (65%). Most subjects (56%) had not completed high school, and over 75% received government financial assistance. Both study condition and acculturation were associated with changes in behavior, intentions and knowledge. Focus group data suggest that English-speaking subjects found it easier to make diet-related changes whereas Spanish-speaking subjects were better at making PA changes. Preliminary pre-post analyses of survey data suggest enhanced self-efficacy, intentions and some behaviors in the intervention group relative to controls. CONCLUSION A “book club” intervention can induce positive changes in nutrition and PA behaviors compared to receiving the book alone. Further, acculturation affects the magnitude and type of changes observed.