Southwest US Latinas’ Weight Health: A Randomized Controlled Trial to Evaluate the De Las Mías App

Abstract

Abstract Background Three-quarters of Mexican American women are overweight vs. 64% of white women. Our preliminary 3-year study tested a culturally tailored app to improve weight health among Latinas in Southwest U.S. Phase II randomized controlled trial (RCT) compared experimental group and control group changes in weight health, attitudes, and behaviors at 6 months. The primary outcome was weight loss of > =5% of a participant's body weight at 6 months (weight loss of this amount has shown significant health benefits). Methods Phase I evaluated a prototype (n = 54). Phase II RCT tested the app (n = 195). Both included adult Latinas with BMI 25-39 in New Mexico who reported wishing to lose weight. Weight was measured at 0-, 3-, and 6-months; an interview was conducted at 9-months. The experimental group was exposed to the app and the control group was exposed to non-culturally specific government education print materials. Results For Phase II participants 35-50 years, 29.4% of those in the experimental group, compared with 12.1% in the control group, had a weight loss of 5% at 6 months (p-value=0.04). Phase II participants <35 years were 3.9X more likely to experience a weight loss of > =5% at 6 months relative to those 50+ years; 9 of 10 participants overall maintained some healthy lifestyle changes at 9 months, with a slightly higher percentage of the experimental than the control group reporting positive changes. Conclusions De Las Mías (bilingual healthy lifestyles platform for Latinas) achieved the most impact among women 35-50 years. The primary weight loss drivers were increased efficacy in making changes in healthy eating/physical activity. The food log was difficult to use; thus, new offerings (in-app communications/videos/interactivity) consider literacy. A Healthy Lifestyle Checklist was added to improve usability. New content targets women <35 and 50+ years; builds efficacy to structure habits; and explores in-app peer support and more rewards on weight management. Key messages Our preliminary study validates and supports culturally tailored innovation for population health. Valuable lessons learned continue to inform ongoing iterations for an effective De Las Mías platform.