Journal of Nutrition Education and Behavior
Research ArticleTu Salud ¡Sí Cuenta! Your Health Matters! A Community-wide Campaign in a Hispanic Border Community in Texas
Introduction
Some of the most effective methods for preventing and managing chronic disease include weight reduction for obese or overweight individuals and improved nutrition1, 2, 3, 4, 5, 6; however, strategies to achieve these outcomes among populations experiencing disparities are still needed. The Guide to Community Preventive Services, a resource intended to provide policy makers and program planners with well-informed and evidence-based information on strategies to prevent disease, recommended the use of community-wide campaigns as a population health strategy to increase physical activity.7, 8 These multicomponent, community-wide campaigns include highly visible media messages, social support, and risk factor screenings and often target eating behaviors; however, the Guide did not explicitly recommend community-wide campaigns for eating behaviors or to improve obesity-related anthropometric outcomes.9 Limited studies tested the effectiveness of the campaigns for eating behavior and anthropometric outcomes, the results of which were mixed.10, 11, 12, 13, 14, 15, 16 Given these mixed results, there is a need to study further the effect of community-wide campaigns on these outcomes, particularly in a US context.
Although the overall need to know the impact of community-wide campaigns and their components on eating and anthropometric outcomes is clear, studying these campaigns within a primarily Hispanic population is important for several reasons. Hispanic individuals are the largest minority group in the US, and the population is expected to continue to grow.17, 18 Furthermore, they have higher rates of obesity than non-Hispanic white individuals.19, 20 Hispanic border communities experience ever greater disparities; they have a higher prevalence of obesity21 and are less likely to meet fruit and vegetable intake guidelines compared with Hispanic people nationally.22 Community-wide campaigns have not been tested as a strategy to affect nutrition and obesity in a predominately Hispanic community or a border community.
This article presents results of a community-wide campaign that compared intervention and comparison communities in an attempt to contribute additional evidence for community-wide campaigns to promote healthy eating behaviors and improve anthropometric outcomes. Many community-wide campaigns did not detail the exposure to and effect of individual components,16, 23, 24 which limits understanding of which components generated positive outcomes or possibly masked important effects of individual components, despite an ineffective overall campaign. The objectives of this study were to assess the associations of exposure to a community-wide campaign with healthy eating, unhealthy eating, and average hip and waist circumference by comparing 2 Hispanic communities, the intervention and comparison groups; and to evaluate the associations of exposure to each of the community-wide campaign components with the outcomes.
Section snippets
Intervention
The Tu Salud ¡Si Cuenta! (Your Health Matters!) (TSSC) community-wide campaign began in 2005 in the Lower Rio Grande Valley on the Texas–Mexico border, primarily in the city of Brownsville, as a Spanish-language campaign. Details of the component implementation and time line from 2005 to 2010 were reported elsewhere.25, 26 Briefly, TSSC was an intervention with multiple components, including television (TV) and radio segments, newsletters, and home-based, individual, and small-group discussions
Results
There was a total sample of 799 individuals who were enrolled and completed the survey at time 3. Table 2 lists the demographics for each group and the total sample. Age, Mexican origin, sex, and marital status were similar between groups (Table 2). However, there was a significant difference in education (P < .001) and employment (P < .01); the comparison group was more educated and employed.
Discussion
The TSSC campaign was specifically designed to reach Hispanic people in a Texas-Mexico border community with culturally and linguistically appropriate media messages and materials. This study provided evidence for the association of exposure to this community-wide campaign with eating behaviors and anthropometric outcomes. Without considering the potential exposure to TSSC, the intervention community had lower rates of unhealthy eating compared with the comparison community. Unhealthy eating
Implications for Research and Practice
Future studies could continue to assess the use of community-wide campaigns in other Hispanic communities, not only those of predominately Mexican origin and border communities, but also more diverse Hispanic communities. Also, future community-wide campaign intervention studies could use longitudinal data collection to assess the impact of community-wide campaign components, both separately and jointly over time, to achieve improvements in eating behaviors and anthropometric measures.
This
Acknowledgments
This research was funded by a predoctoral fellowship from the University of Texas Health Science Center at Houston School of Public Health Cancer Education and Career Development Program through a National Cancer Institute/National Institutes of Health Grant (R25CA57712), and by the UTCO project from the University of Texas Medical Branch, the EXPORT Grant from the National Center on Minority Health and Health Disparities, and the Biostatistics/Epidemiology/Research Design and Community
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Conflict of Interest Disclosures: The authors' conflict of interest disclosures can be found online with this article on www.jneb.org.