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Developing a Culturally Responsive Lifestyle Intervention for Overweight/Obese U.S. Mexicans

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Abstract

Introduction

Hispanics are the largest minority group in the United States, constituting 18 % of the population. Mexicans are the largest Hispanic subgroup and are at disproportionate risk for overweight/obesity. Lifestyle interventions targeting dietary change and physical activity have resulted in significant weight loss in several large randomized clinical trials in the general population, but few studies have tailored interventions to Mexican Americans. We conducted a community needs assessment from 2018 to 2020 in accordance with Domenech-Rodriguez and Wieling’s Cultural Adaptation Process (CAP) model to inform the development of SANOS (SAlud y Nutrición para todOS) (Health and Nutrition for All), a culturally-tailored, community-based diet and lifestyle education and counseling program that addresses overweight/obesity among U.S. Mexicans.

Methods

Five Spanish-language focus groups were conducted until thematic saturation with 31 overweight/obese Mexicans in New York City about their knowledge, priorities, and preferences regarding diet, exercise, and evidence-based strategies for behavioral change. A grounded theory approach was used to analyze the data.

Results

Five themes were identified: (1) A strong desire for tangible information related to diet and health, (2) Family as a primary motivator for behavior change, (3) Desire for group-based motivation and accountability to sustain intervention participation, (4) Belief in short-term goal setting to prevent loss of motivation, and (5) Time and workplace-related barriers to intervention adoption.

Conclusions

Ecological factors such as the effect of acculturation on diet, family members’ role in behavior change, and socioenvironmental barriers to healthy dietary practices and physical activity should be considered when adapting evidence-based treatments for Mexican Americans.

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Availability of Data and Material

The data that support the findings of this study are available from the corresponding author [JL], upon reasonable request.

Code Availability

The NVivo coding utilized in this study is available from the corresponding author [JL], upon reasonable request.

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Funding

This study was funded by the following grants: SANOS (SAlud y Nutricion para todOS) (R01 MD012819-02), CCNY-MSKCC Partnership for Cancer Research, Training, and Community Outreach (5 U54 CA137788-08) and a Cancer Center Support Grant: Population Science Research Program (P30 CA008748). The research presented in this paper is that of the authors and does not reflect the official policy of the NIH.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA

    Jennifer Leng, Florence Lui, Bharat Narang, Leslie Puebla, Javier González, Kathleen Lynch & Francesca Gany

  2. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jennifer Leng & Francesca Gany

  3. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA

    Jennifer Leng & Francesca Gany

  4. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Francesca Gany

Authors
  1. Jennifer Leng
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  2. Florence Lui
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  3. Bharat Narang
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  7. Francesca Gany
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Contributions

JL: Conceptualization, Methodology, Investigation, Formal analysis, Writing—Review & Editing, Funding acquisition, Project administration, Supervision. FL: Formal analysis, Visualization, Writing—Original draft preparation, Writing—Review & Editing. BN: Formal analysis, Supervision, Project administration. LP: Formal analysis, Investigation, Project administration. JG: Investigation, Methodology. KL: Software, Data curation, Formal analysis, Validation, Writing—Original draft preparation, Writing—Reviewing and Editing. FG: Conceptualization, Supervision, Writing—Reviewing and Editing.

Corresponding author

Correspondence to Jennifer Leng.

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Conflict of interest

The authors have no relevant financial or non-financial conflicts of interest to disclose.

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Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for the publication of de-identified data was obtained from all individual participants included in the study.

Ethical Approval

The study was reviewed and approved by MSKCC’s Institutional Review Board.

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Leng, J., Lui, F., Narang, B. et al. Developing a Culturally Responsive Lifestyle Intervention for Overweight/Obese U.S. Mexicans. J Community Health 47, 28–38 (2022). https://doi.org/10.1007/s10900-021-01016-w

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