Tu Salud Si Cuenta: UT Community Outreach Program for Community-based Diabetes Prevention and Control

The proposed intervention research study is building from existing intervention strategies designed for the Mexican American population entitled Tu Salud Si Cuenta (TSSC) or Your Health Matters. This intervention highlights in the media successful role models who have changed their food choices and physical activity levels. In addition the intervention designs environmental changes to help community members carry out recommended behavior change strategies. Outcomes of interest for this study include increased physical activity so as to achieve the CDC/ACSM recommendations of 150 minutes of moderate to vigorous physical activity each week (Haskell et al., 2007), eating 5 servings of fruits and vegetables each day, reducing food portion sizes, and subsequent changes in biomarkers of health.

To test the efficacy of the outreach components of this campaign we are proposing a behavioral intervention trial with two study arms: 1) media campaign or 2) media campaign plus promotora outreach. Data will be collected from the 500 newly enrolled members of the Cameron County Hispanic Cohort, each member from a different household and primarily from quartiles two and four. The measures of this group will be the standard measures collected from the cohort including their medical history, clinical measures and behavioral measures. Two additional measures specified in this proposal will be obtained.

Participants assigned to the TSSC media campaign-only arm of the study will receive a welcome TSSC newsletter upon enrollment to the study, and will receive the same exposure to the TSSC media campaign as other community members not enrolled in the behavioral intervention trial. This includes exposure to the campaign when at the Clinical Research Unit for CCHC data collection via possible viewing of TSSC television segments in the waiting area, and availability of TSSC newsletters. Other possible TSSC campaign exposure will occur as it does for the general public via radio, television and website, using the walking trials, going to farmers market, etc.

Participants assigned to the Promotora plus arm of the study will also receive the initial welcome TSSC newsletter, and other media campaign materials to assure that they are aware of the various media outlets and programming of the campaign. In addition, they will receive a promotora home visit within two weeks of their enrollment. The home visit will consist of the promotora delivering that month's TSSC newsletter, reviewing the newsletter with the participant, emphasizing the role model story, discussing physical activity and healthful food choices using motivational interviewing strategies. These strategies allow the community member to discuss their own goals for making change on these issues while the promotora reflectively listens and summarizes their comments. During the home visit, the promotora will also invite the participant to relevant and accessible opportunities for physical activity and healthful food choices, such as neighborhood walking groups, exercise classes, Farmers' Market, nutrition and cooking classes. Subsequently a monthly home visit will be made by a promotora to deliver the TSSC newsletter, and to follow-up on the initial conversation and referrals. Monthly visits will be made to all 250 participants in the promotora plus arm of the study. Other tools and resources the promotoras might use at the home visits might include showing the participant how to access recipes and resources on the TSSC website, viewing relevant TSSC TV clips on a laptop. Participants will also be invited to an annual celebration of the TSSC media campaign which will feature speakers, cooking and exercise demonstrations and opportunities for networking.

The purpose of this study is to test the efficacy of the outreach elements of the Tu Salud Si Cuenta (TSSC) media campaign, a physical activity and healthful food choice intervention among Mexican Americans in Lower Rio Grande Valley, to achieve behavioral and clinical outcomes.