Changes in Health Behaviors and Self-Rated Health of Participants in Meta Salud : A Primary Prevention Intervention of NCD in Mexico

•Meta Salud produces behavior changes that serve as the foundation for prevention of noncommunicable diseases.•Metabolic equivalent of task values expended per day and proportion of participants meeting Centers for Disease Control and Prevention guidelines for physical activity increased.•Consumption of sugary drinks and whole milk decreased.•Proportion of participants reporting good general health increased.

BackgroundMeta Salud was a community health worker–facilitated intervention for the prevention of noncommunicable diseases in Northern Mexico.ObjectivesThis analysis examined changes in perceived health, eating habits, and physical activity immediately and 3 months after the intervention. The impact on the resulting behavioral and psychological factors are reported.MethodsThis was a nonrandomized intervention study with 1 baseline and 2 post-intervention follow-ups. Outcome evaluation consisted of anthropometric measurements, laboratory tests, and a lifestyle questionnaire.ResultsThe most consistent patterns were increases in metabolic equivalent of task values expended per day from baseline to post-intervention (difference = 996; 95% confidence interval [CI]: 81 to 1,912) and to 3-month follow-up (difference = 1,073; 95% CI: 119 to 2,028); greater likelihood of meeting Centers for Disease Control and Prevention daily exercise recommendations, with an increase from 49% to 60% at post-intervention (OR: 1.6, 95% CI: 1.0 to 2.4) and 63% at follow-up (OR: 1.7, 95% CI: 1.7 to 2.7); lesser likelihood for consuming whole milk, from 38% to 59% (OR: 2.9, 95% CI: 1.8 to 4.7); fewer daily servings of packaged foods, from 0.72 to 0.57 (difference = −0.16; 95% CI: −0.28 to −0.03); fewer days of poor mental health, from 9.3 to 5.8 (difference = −3.4; 95% CI: −5.1 to −1.7); and greater likelihood for reporting good self-rated health, from 41% to 54% post-intervention (OR: 2.1, 95% CI: 1.3 to 3.6) and 57% at follow-up (OR: 2.5, 95% CI: 1.5 to 4.4). Changes in other outcomes, although in the expected direction of association, were not statistically significant.ConclusionsThe study identified important strategies for making feasible dietary changes in the consumption of whole milk, sugary drinks, and packaged foods, yet there is still a need to identify strategies for improving consumption of healthy foods. There was stronger evidence for ways of improving physical activity as opposed to other outcome measures. Overall, it highlights the importance of behavioral and psychosocial factors as key intervention targets in preventing noncommunicable diseases in low- and middle-income countries.