title: A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The Entre Familia: Reflejos de Salud Study.
abstract: Entre Familia: Reflejos de Salud was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker (promotora) model with an entertainment-education component. This process evaluation examined intervention implementation and assessed relationships between implementation factors and dietary change. Participants included 180 mothers randomized to an intervention condition. Process evaluation measures were obtained from participant interviews and promotora notes and included fidelity, dose delivered (i.e., minutes of promotora in-person contact with families, number of promotora home visits), and dose received (i.e., participant use of and satisfaction with intervention materials). Outcome variables included changes in vegetable intake and the use of behavioral strategies to increase dietary fiber and decrease dietary fat intake. Participant satisfaction was high, and fidelity was achieved; 87.5% of families received the planned number of promotora home visits. In the multivariable model, satisfaction with intervention materials predicted more frequent use of strategies to increase dietary fiber (p ≤ .01). Trends suggested that keeping families in the prescribed intervention timeline and obtaining support from other social network members through sharing of program materials may improve changes. Study findings elucidate the relationship between specific intervention processes and dietary changes.
authors: San Diego State University, San Diego, CA, USA Institute for Behavioral and Community Health, San Diego, CA, USA eschmied@rohan.sdsu.edu.
authors: Emily
authors: E
authors: Schmied
authors: University of North Carolina at Chapel Hill, NC, USA.
authors: Humberto
authors: H
authors: Parada
authors: Institute for Behavioral and Community Health, San Diego, CA, USA.
authors: Lucy
authors: L
authors: Horton
authors: Clinicas de Salud del Pueblo, Inc., Brawley, CA, USA.
authors: Leticia
authors: L
authors: Ibarra
authors: San Diego State University, San Diego, CA, USA Institute for Behavioral and Community Health, San Diego, CA, USA.
authors: Guadalupe
authors: G
authors: Ayala
mesh_terms: D000328:Adult; D003150:Community Health Workers / Q000193:education; D004032:Diet; D004043:Dietary Fiber; D005190:Family / Q000208:ethnology; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D015438:Health Behavior / Q000208:ethnology*; D006266:Health Education / Q000379:methods*; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D009035:Mothers; D017063:Outcome Assessment, Health Care; D014675:Vegetables
keywords: Latino; diet; family health; nutrition; process evaluation