Abstract
Background In the USA, 77% of Hispanic women age 20 and older are classified as overweight or obese. There is evidence that Hispanics tend to be less successful than non-Hispanic whites in standard weight-loss interventions. This study assessed the feasibility of a culturally-tailored behavioral weight-loss intervention specifically designed for Spanish-speaking women of Mexican origin.
Methods This 6-month intervention consisting of weekly sessions was based on approaches previously used successfully with English-speaking participants in the PREMIER and Weight Loss Maintenance trials. Cultural adaptations were implemented throughout the program based on information derived from focus groups, available literature, and a multidisciplinary team that included Mexican experts in behavioral interventions and nutritional anthropology. The intervention was conducted entirely in Spanish. Beyond language, specific cultural adaptations included:
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“Grupos de mujeres” (“women-only” groups) of a wide range of age—covering topics central to the immigration experience (e.g., the loss of social networks, differing body-shape ideals in Mexican and American cultures, and the pressure of maintaining Mexican traditions while adopting “American ways”).
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Focusing on staple foods in the Mexican diet: returning to a traditional diet, how to make healthy choices.
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Providing basic instruction on nutrition, and hands-on training on standard food measurement for portion control.
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Addressing Mexican folk remedies and traditional beliefs regarding food and diet (e.g. “hot” and “cold” foods, “empacho,” etc.).
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Developing food-intake journals for people of limited literacy.
Results The recruitment strategies used resulted in a significantly larger-than-expected response. There were 47 participants in the study. Thirty-one participants completed the intervention and had main outcome data available. Participants did not complete the intervention because they became pregnant (2), had unexpected changes in school schedules (2), relocated to Mexico due to immigration problems (3), needed to follow agricultural work (6), unknown reasons (3). After 6 months, average weight decreased by 7.26 kg (16 lb), p< .0001.
Conclusions Mexican-American women have previously been underrepresented in weight-loss interventions; however, this study suggests that culturally-congruent recruitment methods can successfully attract this population to lifestyle intervention programs, and that carefully-tailored culturally adapted weight-loss interventions are feasible and potentially effective among Spanish-speaking Mexican-American women.
