2. University of Nebraska Medical Center College of Public Health-Center for Global Health and Development, USA.
Background: Mexican-American children have the highest rates of childhood obesity of any ethnic group . Because Mexican-American mothers follow the advice of abuelas (respected grandmothers in the Mexican-American community) more than that of health care providers , this pilot study evaluated the efficacy of using abuelas to deliver a motivational interviewing intervention to encourage Mexican-American mothers to limit their children's low-nutritive simple carbohydrate intake. Specific questions were whether or not 1) abuelas could deliver a motivational interviewing intervention, 2) abuelas could recruit and retain participants, and 3) mothers altered their attitudes/beliefs, perceived norms, perceived behavioral control (self-efficacy), intent and behavior of limiting their children's low-nutritive simple carbohydrate intake.
Methods: Two abuelas were recruited and trained to deliver a motivational interviewing intervention. The abuelas recruited 6 mothers to participate in the study. Assessments and interventions occurred at baseline and 1 month. Attitude/beliefs, perceived norm and perceived behavioral control (self-efficacy) were measured using sub-scales of the Healthy Diet Survey , intent was measured using an Intent Questionnaire, and behavioral change was assessed using a short-form food frequency questionnaire. A Wilcoxon test (α=0.05) was used to evaluate changes in responses between baseline and 1 month.
Results: The abuelas were successfully trained in motivational interviewing and reliably delivered the intervention. The abuelas recruited 6 mothers and all 6 participated through the entire study. All mothers felt it was important to limit their children's' low-nutritive simple carbohydrate intake (M=9.83, SD=.408) and scored their readiness to change as highly or extremely likely. Confidence in their ability to limit their children's low-nutritive simple carbohydrate intake increased (z=-2.041, p=.041) between baseline (M=6.33, SD=1.97) and 1 month (M=9.67, SD=.82) for 5 of the mothers. The sixth scored her confidence as 10 (the maximum) at both assessments. Responses to the food frequency questionnaire suggest a trend towards limiting their children's low-nutritive simple carbohydrate intake.
Conclusions: This study demonstrated that recruitment, retention, and program delivery using abuelas were successful and the results suggest a trend towards mothers limiting their children's low-nutritive simple carbohydrates.
Keywords: Hispanic, abuela, childhood obesity, mothers, simple carbohydrates