Latino Mothers as Primary Agents of Change

• ClinicalTrials.gov Identifier: NCT02441049
• Recruitment Status: Unknown
• First Posted: May 12, 2015
• Last Update Posted: April 21, 2020
• Sponsor: San Diego State University
• Collaborator: American Cancer Society, Inc.
• Information provided by (Responsible Party): Guadalupe X. Ayala, San Diego State University

Study Description

Brief Summary:

Entre Familia was a 4-year randomized controlled trial funded by the American Cancer Society. The study was conducted in Imperial County, California, and involved a partnership between the Institute for Behavioral and Community Health at San Diego State University and Clínicas de Salud del Pueblo, Inc. a private, non-profit corporation providing comprehensive primary care services to residents throughout Imperial and Riverside Counties. The investigators enrolled 361 Latina mothers and one of their children aged between 7 and 13 years old; in 25% of families, the father was also enrolled. Participants were randomly assigned to either an intervention or delayed-treatment control condition. The intervention consisted of a community health worker (or promotora)-delivered home-based intervention to promote healthy eating. The promotoras used a telenovela DVD series and accompanying manual, both written and produced by study staff. The intervention was delivered through 11 home visits and 4 support telephone calls over a 4 month period. Participants in the delayed-treatment condition received intervention materials when evaluation assessments had been completed. Evaluation measures were taken at baseline, 4 months (immediate post-intervention) and 10 months (6-months post intervention). Participants completed a self-report interview with study staff at each time point. Height and weight measurements were also collected for the mothers and children. The primary outcomes were changes in mothers' daily fruit and vegetable intake. Secondary outcomes for mothers, children and fathers included changes in fat intake, sugary beverage intake, parenting strategies, and perceived barriers to healthy eating.

Condition or disease	Intervention/treatment	Phase
Eating Behavior	Behavioral: Home-based promotora family intervention	Not Applicable

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 361 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Prevention
• Official Title: Latino Mothers as Primary Agents of Change
• Study Start Date: July 2007
• Actual Primary Completion Date: February 2011
• Estimated Study Completion Date: September 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: Home-based promotora intervention; Study participants and their families received the home-based promotora family intervention	Behavioral: Home-based promotora family intervention; A promotora-delivered family intervention in the participant's home. Promotoras used a telenovela-style DVD and accompanying manual to deliver 11 home sessions to the family, and 4 support telephone calls, over a 4 month period.; Other Name: Entre Familia: Reflejos de Salud
No Intervention: Delayed treatment control; Study participants received intervention materials after the final study evaluation measures were taken, 10 months post-baseline.

Outcome Measures

Primary Outcome Measures :

1. Change in mother daily fruit and vegetable intake in the past month between baseline, immediate-post intervention and 6-months post-intervention, assessed using the NCI Fruit and Vegetable All-Day Screener [ Time Frame: Baseline, 4 months, 10 months ]

Secondary Outcome Measures :

1. Child, father: change in daily fruit and vegetable intake in the past month between baseline, immediate-post intervention and 6-months post-intervention, assessed using the NCI Fruit and Vegetable All-Day Screener [ Time Frame: Baseline, 4 months, 10 months ]
2. Mother, child, father: change in monthly fruit and vegetable variety between baseline, immediate-post intervention and 6-months post-intervention, assessed using self-reported intake of 32 fruits and 43 vegetables [ Time Frame: Baseline, 4 months, 10 months ]
3. Mother, father: change in perceived quality of diet between baseline, immediate-post intervention and 6-months post-intervention, assessed using one item from the 2005-06 NHANES (Diet Behavior and Nutrition module) [ Time Frame: Baseline, 4 months, 10 months ]
4. Mother, father: change in parenting strategies between baseline, immediate-post intervention and 6-months post-intervention, assessed using a modified version of the PEAS scale [ Time Frame: Baseline, 4 months, 10 months ]
5. Mother: change in social support for fruit and vegetable intake between baseline, immediate-post intervention and 6-months post-intervention, assessed using a modified version of preexisting F&V shopping practices and social support scales [ Time Frame: Baseline, 4 months, 10 months ]
6. Mother, child, father: change in weekly fast food intake between baseline, immediate-post intervention and 6-months post-intervention, assessed by asking for self-reported number of days in a typical week the respondent ate at fast food restaurants [ Time Frame: Baseline, 4 months, 10 months ]
7. Mother, father: change in perceived barriers to obtaining and consuming fruits and vegetables between baseline, immediate-post intervention and 6-months post-intervention, assessed using 11-items including ease of purchasing F&V in the neighborhood [ Time Frame: Baseline, 4 months, 10 months ]
8. Mother, father: change in fat intake between baseline, immediate-post intervention and 6-months post-intervention, assessed using the NCI Multifactor Fat Screener [ Time Frame: Baseline, 4 months, 10 months ]

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

Mothers:

• must self-identify as Latina,
• must be able to read and speak Spanish,
• must be at least 18 years old,
• must be a resident of Imperial County,
• and must plan to reside in the county for the 10 month study duration.

Children (both genders):

• must be between the ages of 7-13 years,
• must reside with his/her mother and her spouse/partner for at least 4 days of the week.

Exclusion Criteria:

• Families who intend to move away from Imperial County before the end of the study, and families with a family member on a medically-prescribed diet

Contacts and Locations

Locations

United States, California

San Diego State University Research Foundation

San Diego, California, United States, 92123

Sponsors and Collaborators

San Diego State University

American Cancer Society, Inc.

Investigators

• Principal Investigator: Guadalupe X Ayala, PhD, MPH; San Diego State University

More Information

Publications of Results:

Horton LA, Parada H, Slymen DJ, Arredondo E, Ibarra L, Ayala GX. Targeting children's dietary behaviors in a family intervention: 'Entre familia: reflejos de salud'. Salud Publica Mex. 2013;55 Suppl 3:397-405.

Ayala GX, Ibarra L, Horton L, Arredondo EM, Slymen DJ, Engelberg M, Rock CL, Hernandez E, Parada H, Elder JP. Evidence supporting a promotora-delivered entertainment education intervention for improving mothers' dietary intake: the Entre Familia: Reflejos de Salud Study. J Health Commun. 2015;20(2):165-76. doi: 10.1080/10810730.2014.917747. Epub 2014 Nov 6.

Schmied E, Parada H, Horton L, Ibarra L, Ayala G. A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The Entre Familia: Reflejos de Salud Study. Health Educ Behav. 2015 Oct;42(5):583-92. doi: 10.1177/1090198115577375. Epub 2015 Mar 25.

Ayala, G.X., Ibarra, L., Arredondo, E., Horton, L., Hernandez, E., Parada, H., Slymen, D., Rock, C., Engelberg, M., Elder, J.P. (2011). Promoting healthy eating by strengthening family relations: Design and implementation of the Entre Familia: Reflejos de Salud intervention. In R. Elk & H. Landrine (Eds.), Cancer Disparities: Causes and Evidence-Based Solutions. Springer.

Schmied EA, Parada H, Horton LA, Madanat H, Ayala GX. Family support is associated with behavioral strategies for healthy eating among Latinas. Health Educ Behav. 2014 Feb;41(1):34-41. doi: 10.1177/1090198113485754. Epub 2013 May 27.

Parada H, Ayala GX, Horton LA, Ibarra L, Arredondo EM. Latino fathers' feeding-related parenting strategies on children's eating. Ecol Food Nutr. 2016 May-Jun;55(3):292-307. doi: 10.1080/03670244.2016.1161616. Epub 2016 Apr 11.

Soto SC, Arredondo EM, Horton LA, Ayala GX. Validation of the modified Parenting Strategies for Eating and Physical Activity Scale-Diet (PEAS-Diet) in Latino children. Appetite. 2016 Mar 1;98:55-62. doi: 10.1016/j.appet.2015.12.003. Epub 2015 Dec 15.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Arredondo EM, Ayala GX, Soto S, Slymen DJ, Horton LA, Parada H, Campbell N, Ibarra L, Engelberg M, Elder JP. Latina mothers as agents of change in children's eating habits: findings from the randomized controlled trial Entre Familia: Reflejos de Salud. Int J Behav Nutr Phys Act. 2018 Oct 1;15(1):95. doi: 10.1186/s12966-018-0714-0.

Horton LA, Ayala GX, Slymen DJ, Ibarra L, Hernandez E, Parada H, Rock CL, Arredondo EM, Elder JP. A Mediation Analysis of Mothers' Dietary Intake: The Entre Familia: Reflejos de Salud Randomized Controlled Trial. Health Educ Behav. 2018 Aug;45(4):501-510. doi: 10.1177/1090198117742439. Epub 2017 Dec 6.

• Responsible Party: Guadalupe X. Ayala, Professor, San Diego State University
• ClinicalTrials.gov Identifier: NCT02441049
• Other Study ID Numbers: G00007105
• First Posted: May 12, 2015
• Last Update Posted: April 21, 2020
• Last Verified: April 2020

Keywords provided by Guadalupe X. Ayala, San Diego State University:

Latino; Hispanic; Diet; Family health; Promotora; Intervention