title: Healthy immigrant families: Participatory development and baseline characteristics of a community-based physical activity and nutrition intervention.
abstract: BACKGROUND
  US immigrants often have escalating cardiovascular risk. Barriers to optimal physical activity and diet have a significant role in this risk accumulation.
  
  
  METHODS
  We developed a physical activity and nutrition intervention with immigrant and refugee families through a community-based participatory research approach. Work groups of community members and health scientists developed an intervention manual with 12 content modules that were based on social-learning theory. Family health promoters from the participating communities (Hispanic, Somali, Sudanese) were trained to deliver the intervention through 12 home visits during the first 6 months and up to 12 phone calls during the second 6 months. The intervention was tested through a randomized community-based trial with a delayed-intervention control group, with measurements at baseline, 6, 12, and 24 months. Primary measurements included accelerometer-based assessment of physical activity and 24-hour dietary recall. Secondary measures included biometrics and theory-based instruments.
  
  
  RESULTS
  One hundred fifty-one individuals (81 adolescents, 70 adults; 44 families) were randomized. At baseline, mean (SD) time spent in moderate-to-vigorous physical activity was 64.7 (30.2) minutes/day for adolescents and 43.1 (35.4) minutes/day for adults. Moderate dietary quality was observed in both age groups. Biometric measures showed that 45.7% of adolescents and 80.0% of adults were overweight or obese. Moderate levels of self-efficacy and social support were reported for physical activity and nutrition.
  
  
  CONCLUSIONS
  Processes and products from this program are relevant to other communities aiming to reduce cardiovascular risk and negative health behaviors among immigrants and refugees.
  
  
  BACKGROUND
  This trial was registered at Clinicaltrials.gov (NCT01952808).
authors.affiliation: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States. Electronic address: wieland.mark@mayo.edu.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wieland
authors.affiliation: Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Weis
authors.affiliation: Department of Research Administration, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Marcelo M K
authors.initials: MM
authors.lastname: Hanza
authors.affiliation: Department of Nursing, Winona State University, Rochester, Minnesota, United States.
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Meiers
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Christi A
authors.initials: CA
authors.lastname: Patten
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.affiliation: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Njeru
authors.affiliation: Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Adeline
authors.initials: A
authors.lastname: Abbenyi
authors.affiliation: Division of Endocrinology, Mayo Clinic, Scottsdale, Arizona, United States.
authors.forename: James A
authors.initials: JA
authors.lastname: Levine
authors.affiliation: Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, Minnesota, United States.
authors.forename: Miriam
authors.initials: M
authors.lastname: Goodson
authors.affiliation: Language Services, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Maria Graciela D
authors.initials: MG
authors.lastname: Porraz Capetillo
authors.affiliation: Somali Community Resettlement Services, Rochester, Minnesota, United States.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Osman
authors.affiliation: Somali Community Resettlement Services, Rochester, Minnesota, United States.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Hared
authors.affiliation: Hawthorne Education Center, Rochester, Minnesota, United States.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Nigon
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Irene G
authors.initials: IG
authors.lastname: Sia
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D055812:Community-Based Participatory Research; D000072001:Diet, Healthy; D054242:Emigrants and Immigrants; D015444:Exercise; D005190:Family; D005192:Family Health; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods*; D000070497:Healthy Lifestyle; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000628:therapy; D050177:Overweight / Q000453:epidemiology / Q000628:therapy; D012036:Refugees; D020377:Self Efficacy; D000067570:Social Learning; D012998:Somalia / Q000208:ethnology; D013397:Sudan / Q000208:ethnology
keywords: Community-based participatory research; Dietary quality; Immigrant refugee health; Physical activity