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Article

Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border

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Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA
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Department of Physician Assistant, College of Health Professions, University of Texas Rio Grande Valley, 1201 West University Blvd., Edinburg, TX 78539, USA
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Postdoctoral Fellow, National Cancer Institute Cancer Control Research Training Program, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA
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Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA
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Division of Biostatistics, Department of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA
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Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Rebecca E. Lee, Jennie L. Hill, Jacob Szeszulski and Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2022, 19(8), 4514; https://doi.org/10.3390/ijerph19084514
Received: 31 January 2022 / Revised: 1 April 2022 / Accepted: 6 April 2022 / Published: 8 April 2022
This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into “low exposure” (2–3 visits) and “high exposure” (4–5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53–0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9–265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65–2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10–1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelity. View Full-Text
Keywords: community-wide campaign; community health worker; physical activity; behavioral dietary intervention; built environment; implementation science; dissemination research; health behavior promotion; Latino community health; U.S.-Mexico border health community-wide campaign; community health worker; physical activity; behavioral dietary intervention; built environment; implementation science; dissemination research; health behavior promotion; Latino community health; U.S.-Mexico border health
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MDPI and ACS Style

Yeh, P.G.; Reininger, B.M.; Mitchell-Bennett, L.A.; Lee, M.; Xu, T.; Davé, A.C.; Park, S.K.; Ochoa-Del Toro, A.G. Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border. Int. J. Environ. Res. Public Health 2022, 19, 4514. https://doi.org/10.3390/ijerph19084514

AMA Style

Yeh PG, Reininger BM, Mitchell-Bennett LA, Lee M, Xu T, Davé AC, Park SK, Ochoa-Del Toro AG. Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border. International Journal of Environmental Research and Public Health. 2022; 19(8):4514. https://doi.org/10.3390/ijerph19084514

Chicago/Turabian Style

Yeh, Paul Gerardo, Belinda M. Reininger, Lisa A. Mitchell-Bennett, Minjae Lee, Tianlin Xu, Amanda C. Davé, Soo Kyung Park, and Alma G. Ochoa-Del Toro. 2022. "Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border" International Journal of Environmental Research and Public Health 19, no. 8: 4514. https://doi.org/10.3390/ijerph19084514

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