Set in the Lower Rio Grande Valley of South Texas, along the US Mexico border, a unique environment for examining health disparities in an ethnic minority population, the overarching long term goals of the proposed community intervention are: 1) the prevention (weight control) or reduction of overweight and obesity;and (2) the prevention, delay of the onset, or improved management of diabetes in a population of urban and rural adult Mexican Americans. Framed within these long-term goals, three specific aims are proposed for this study:
Aim #1) to assess the efficacy of a culturally tailored, community embedded 12-week health education intervention, field tested during Phase I, known as Sabor (flavor in Spanish) in a random cluster design of 32 randomized sites from a total of 202 sites throughout the LRGV and a minimum of 782 participants;
Aim #2) to support participants'agency in changing and sustaining a healthy lifestyle through a 24-week effort directed at minimizing attrition, while reinforcing participants'social support;
Aim #3) to strengthen and advance community based participatory research through collaborative and equitable co-learning research opportunities;and the application of research findings to address community health conditions. In conducting the above stated aims, a mixed methods approach will be employed that facilitates the examination and assessment of aims 1-3.
For aim #1, established quantifiable procedures will be employed in assessing the efficacy of Sabor when compared to an advice oriented traditional health education program, known as Healthy Living, Buena Vida.
For aim #2, qualitative strategies will be used mostly to evaluate an effort designed to reduce attrition, while reinforcing participants'social support.
Aim #2 will be conducted with participants from all sites (treatment and attention control), following the completion of the 12-week posttest observation and ending the week prior to the 36 week posttest.
For aim #3, established procedural strategies for CBPR, as proposed by Israel et al (63, 64) and Minkler and Wallerstein (82) will remain the basis for strengthening and advancing the short and long term goals of the Advisory Health Coalition, while continuing to frame the study's objectives and procedures within an ecological oriented theoretical approach.
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