Latina mothers as agents of change in children's eating habits: findings from the randomized controlled trial Entre Familia: Reflejos de Salud

Elva M Arredondo, Guadalupe X Ayala, Sandra Soto, Donald J Slymen, Lucy A Horton, Humberto Parada, Nadia Campbell, Leticia Ibarra, Moshe Engelberg, John P Elder, Elva M Arredondo, Guadalupe X Ayala, Sandra Soto, Donald J Slymen, Lucy A Horton, Humberto Parada, Nadia Campbell, Leticia Ibarra, Moshe Engelberg, John P Elder

Abstract

Background: Few children consume sufficient servings of fruits and vegetables. Interventions aiming to improve children's dietary intake often target parent level factors, but limited research has examined the mediating role of parental factors on children's dietary intake. This study examined 10-month follow up data from the Entre Familia: Reflejos de Salud (Within the Family: Reflections of Health) trial to investigate (1) intervention effects on children's dietary intake, both sustained and new changes, and (2) whether changes in mothers' dietary intake, her parenting strategies, and behavioral strategies to promoting healthy eating in the home mediated changes in children's dietary intake.

Methods: Participants were 361 Mexican-origin families living in Imperial County, California. Families were randomly assigned to a 4-month dietary intervention or a delayed treatment control group. The intervention was delivered by promotoras (community health workers) via home visits and telephone calls. Assessments occurred at baseline, and 4- and 10-months post-baseline.

Results: At 10-months post-baseline, sustained intervention effects were observed on children's reported intake of varieties of vegetables, with differences getting larger over time. However, differential intervention effects on fast food were not sustained due to significant reductions in the control group compared with smaller changes in the intervention group. New intervention effects were observed on servings of sugar-sweetened beverages. However, the intervention continued to have no effect on children's reported fruit and vegetable servings, and varieties of fruits consumed. Mother-reported behavioral strategies to increase fiber and lower fat mediated the relationship between the intervention and children's intake of varieties of vegetables. Mothers' percent energy from fat and behavioral strategies to lower fat were mediators of children's daily servings of sugar-sweetened beverages.

Conclusions: This study suggests that a promotora-led family based intervention can provide mothers with skills to promote modest changes in children's diet. Examining the parent related mechanisms of change will inform future interventions on important targets for improving children's diet.

Trial registration: https://ichgcp.net/clinical-trials-registry/NCT02441049" title="See in ClinicalTrials.gov">NCT02441049 . Retrospectively registered 05.06.2015.

Keywords: Diet; Family health; Family intervention; Health behavior; Latino; Nutrition.

Conflict of interest statement

Ethics approval and consent to participate

Study procedures were approved by San Diego State University’s Institutional Review Board (#288031). Free and informed consent of study participants was obtained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Entre Familia Consolidated Standards of Reporting Trials (CONSORT) flow diagram. Based on results from the Entre Familia: Reflejos de Salud study, carried out in Imperial County, California, USA between 2007 and 2012

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