142nd APHA Annual Meeting and Exposition

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301829
Mediators and moderators of the effectiveness of a community health worker intervention that improved dietary outcomes in pregnant Latina women

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Megha Shah, MD, MSc , Department of Family Medicine, University of Michigan/Robert Wood Johnson Clinical Scholars Program, Ann Arbor, MI
Edith Kieffer, MPH, PhD , School of Social Work, University of Michigan, Ann Arbor, MI
Hwajung Choi, PhD , Department of Internal Medicine, Univeristy of Michigan, Ann Arbor, MI
Michele Heisler, MD MPA , University of Michigan, Ann Arbor, MI
Christina Schumann, MPH, RD , Community Health and Social Services Center (CHASS), Inc, Detroit
Background: Using community-based participatory research principles, a randomized controlled trial compared the 11-week Healthy MOMs CHW-led healthy lifestyle intervention for pregnant Latina women with a comparison group that received group pregnancy education from a health professional.  Healthy MOMs participants had significantly greater improvement in dietary behaviors than the comparison group. 

Objective:  To improve the development and targeting of future interventions for high-risk pregnant women, we examined potential mechanisms (mediators) and baseline characteristics (moderators) associated with intervention effects.  

Measurements: Outcomes included self-reported vegetable, fiber, total fat, and added sugar consumption.  Mediators included changes in intention to eat healthy, healthy food beliefs, perceived control to make healthy food choices, and support from CHW and peer groups. Moderators were age, primary language, participating in the Women, Infant, and Children program and the Supplemental Nutritional Assistance Program, spousal support, body mass index, access to healthy food options, and baseline perceived control to make healthy choices.

Results: No examined mediators were associated with intervention effects, though there was a trend toward mediation of added sugar consumption by multiple mediators.  Among examined moderators, improvements in vegetable consumption were greatest for women who reported high spousal support at baseline (p<.05).  Women younger than 30 were more likely to reduce added sugar consumption than older women (p<.05), and participants who reported higher baseline perceived control were most likely to reduce fat consumption (p<.05).  

Conclusion: Future interventions with pregnant Latinas may benefit from targeting specific dietary goals.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs

Learning Objectives:
Evaluate potential mechanisms for the Healthy MOMs intervention effectiveness Evaluate potential baseline characteristics of participants that were associated with dietary changes in the Health MOMs intervention Discuss possible rationale for the mediator and moderator effects of the Healthy MOMs intervention effect

Keyword(s): Latinos, Community Health Workers and Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the PI of Healthy Mothers on the Move, the RCT from which the data for this paper were derived. I was fully involved in all aspects of the study and all stages of presentation study design, planning and preparation. I am second author of the presentation.
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.

Back to: 4396.0: Chronic Disease Treatment and Prevention Programs