Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing.

Abstract

To determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention. Quasi-experimental evaluation. El Paso, Texas. Among 656 baseline participants, 374 (54%) completed the 12-month assessment. In Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6months were identical across conditions. CHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale. Regression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment. Participants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23kg (2.71 lbs.) and their BFP declined 2% over 12months. Findings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.