Long-Term Effects of a Communication Intervention for Spanish-Dominant Latinas

BackgroundFew studies compare the influence of different types of dietary interventions on the dietary practices of Latinas in the short and long term. The present study examined the 1-year impact of two innovative behavior-change approaches to reduce dietary fat and increase fiber.DesignThree-group randomized controlled trial: (1) personalized dietary counseling via lay heath advisors (promotoras) plus tailored print materials delivered via the mail, (2) tailored mailed print materials only, and (3) targeted mailed “off-the-shelf” materials.Setting/ParticipantsA total of 357 Latinas were randomly assigned to the three aforementioned conditions.InterventionPromotora and tailored print materials.Main Outcome MeasuresFat intake (total grams of fat and percent calories from dietary fat) and number of grams of dietary fiber.ResultsEarlier work reported that at immediate post-intervention the promotora group achieved significantly lower levels of total fat grams, and lower levels of energy intake, total saturated fat, total carbohydrates, glucose, and fructose than the targeted group. However, the present longitudinal analyses suggest that the effects achieved by the promotoras dissipated over the 12-month follow-up period while the effects of the tailored group concurrently improved.ConclusionsThe high interactivity (i.e., calls, visits) of the promotora condition may have been the most salient reinforcer and may have led to further tailoring, making this type of intervention more effective than the comparison groups in the short term. Further research should explore whether booster sessions involving promotoras help to maintain the impact over time.