title: Effects of Food Label Use on Diet Quality and Glycemic Control Among Latinos With Type 2 Diabetes in a Community Health Worker-Supported Intervention.
abstract: OBJECTIVE
  To determine the impact of an intervention led by community health workers (CHWs) on food label use and to assess whether food label use and diet quality mediate the intervention's impact on glycemic control.
  
  
  METHODS
  From 2006 to 2010, 203 Latinos (intervention group, n = 100; control group, n = 103) in Hartford County, Connecticut, with type 2 diabetes were randomized to an intervention that included 17 CHW-led home-based sessions over a 12-month period in addition to the standard of care available in both study arms. Data on food label use, diet quality, covariates, and glycated hemoglobin (HbA1c) were collected at baseline and at 3, 6, 12, and 18 months. Data were analyzed via mixed effects and multilevel structural equation modeling.
  
  
  RESULTS
  Food label use in the intervention (vs control) group was significantly higher at 3, 12, and 18 months (odds ratio = 2.99; 95% confidence interval = 1.69, 5.29). Food label use and diet quality were positive mediators of improved HbA1c levels.
  
  
  CONCLUSIONS
  Culturally tailored interventions led by CHWs could increase food label use. Also, CHW-delivered food label education may lead to better diet quality and improve glycemic control among Latinos with type 2 diabetes.
authors.affiliation: Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Grace
authors.initials: G
authors.lastname: Kollannoor-Samuel
authors.affiliation: Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Fatma M
authors.initials: FM
authors.lastname: Shebl
authors.affiliation: Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Sofia
authors.initials: S
authors.lastname: Segura-Pérez
authors.affiliation: Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Chhabra
authors.affiliation: Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Sonia
authors.initials: S
authors.lastname: Vega-López
authors.affiliation: Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Rafael
authors.initials: R
authors.lastname: Pérez-Escamilla
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003150:Community Health Workers; D003237:Connecticut; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000208:ethnology; D004032:Diet / Q000379:methods*; D005260:Female; D005515:Food Labeling / Q000706:statistics & numerical data*; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin