Results of a Behavioral Nutrition Program for Mexican-Heritage Children in the Lower Rio Grande Valley of Texas

Background Systemic, structural, and social factors negatively influence nutrition for Latino/a children, and there are racial/ethnic disparities in dietary intake of fruits and vegetables (FV) and body mass index (BMI). The ¡Haz Espacio para Papi! (HEPP, Make Room for Daddy!) program was a father-focused, family-centered program to support nutrition and physical activity in Mexican-heritage families. Objective Examine the effects of a behavioral nutrition program on dietary intake of FV and BMI for Mexican-heritage children. Study Design, Settings, Participants A modified stepped-wedge design was used to evaluate the program, which was conducted from summer 2019 through winter 2020, in five neighborhood clusters along the Texas-Mexico border. Children were 9-11 years at enrollment. Promotoras led in-person group sessions with experiential nutrition education and measurements at pre-test, post-test (6 weeks), and maintenance (3-4 months after post-test). Measurable Outcome/Analysis Promotoras measured height and weight and used the Veggie Meter® to collect instant skin carotenoid scores (SCS) as a biomarker for dietary FV intake. A SAS macro calculated age- and sex-adjusted BMI. Within-person changes were calculated for SCS and BMI percentile and BMI z-score. Analyses of variance and linear mixed-effects models were used to determine differences in outcomes. Results The program enrolled 59 children (10 years old, 100% Mexican-heritage, 56.1% female). Children experienced decreases in SCS overall, though an increase of 16.1 ± 18.1 points was observed in one group. Children who may have had access to school meal programs did not show greater increases in SCS. Overall, children had greater reductions in BMI during the program compared to the control period and sustained reductions in BMI at maintenance. Conclusion Preliminary results showed no overall effect for instant skin carotenoid score, though some groups showed a greater increase during the program versus control period. There were promising results for BMI at post-test and somewhat sustained effects at maintenance. Our findings provided evidence for strengths-based approaches in behavioral nutrition and suggest strengthening school meal programs to include carotenoid rich FV. Funding USDA This research was supported by U.S. Department of Agriculture National Institute of Food and Agriculture under award number 2015-68001-23234 for the Salud para Usted y Su Familia (Health for You and Your Family, SPUSF), and through another USDA NIFA award (2021-77040-34877) for the Nutrition LEADers Learning Community. Systemic, structural, and social factors negatively influence nutrition for Latino/a children, and there are racial/ethnic disparities in dietary intake of fruits and vegetables (FV) and body mass index (BMI). The ¡Haz Espacio para Papi! (HEPP, Make Room for Daddy!) program was a father-focused, family-centered program to support nutrition and physical activity in Mexican-heritage families. Examine the effects of a behavioral nutrition program on dietary intake of FV and BMI for Mexican-heritage children. A modified stepped-wedge design was used to evaluate the program, which was conducted from summer 2019 through winter 2020, in five neighborhood clusters along the Texas-Mexico border. Children were 9-11 years at enrollment. Promotoras led in-person group sessions with experiential nutrition education and measurements at pre-test, post-test (6 weeks), and maintenance (3-4 months after post-test). Promotoras measured height and weight and used the Veggie Meter® to collect instant skin carotenoid scores (SCS) as a biomarker for dietary FV intake. A SAS macro calculated age- and sex-adjusted BMI. Within-person changes were calculated for SCS and BMI percentile and BMI z-score. Analyses of variance and linear mixed-effects models were used to determine differences in outcomes. The program enrolled 59 children (10 years old, 100% Mexican-heritage, 56.1% female). Children experienced decreases in SCS overall, though an increase of 16.1 ± 18.1 points was observed in one group. Children who may have had access to school meal programs did not show greater increases in SCS. Overall, children had greater reductions in BMI during the program compared to the control period and sustained reductions in BMI at maintenance. Preliminary results showed no overall effect for instant skin carotenoid score, though some groups showed a greater increase during the program versus control period. There were promising results for BMI at post-test and somewhat sustained effects at maintenance. Our findings provided evidence for strengths-based approaches in behavioral nutrition and suggest strengthening school meal programs to include carotenoid rich FV.