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Background: Physical activity (PA) is linked to many health benefits. However, many children and adults do not meet PA recommendations. Specifically, Mexican-heritage (MH) families are less physically active and at greater risk for obesity and related co-morbidities than the general population. Culturally-tailored programs are needed to support MH families in healthy PA behaviors. Purpose: This article describes creation and pilot testing of "¡Haz Espacio para Papi!" (Make Room for Daddy!), a PA curriculum tailored for MH families. Methods: Academic-based and "promotora"-researchers developed a six-week curriculum including weekly interactive lessons provided on weekends and take-home challenges focused on father-child co-participation in light-to-moderate PA. Participating families consisted of child (aged 9-11), mother, and father. Weekly telephone calls were placed to adult participants to secure qualitative evaluation data. Results: Most families reported trying program activities at home between sessions. Families reported spending time together as the most valuable part of the program, specifically engaging in father/child activities. Very few families reported suggestions to change program. Discussion: Positive responses by families speak to the success of culturally and contextually tailoring this curriculum to MH families. Translation to Health Education Practice: This curriculum provides evidence of a culturally and contextually tailored program for MH families.

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. 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. [ABSTRACT FROM AUTHOR]

To determine the efficacy of The Happy Kitchen/La Cocina Alegre® (THK/LCA) program to improve nutrition outcomes of low-income Texans. The THK/LCA program draws from established health promotion and nutrition education models, including the Social-Ecological Model, the Health Belief Model, and Social Cognitive Theory. Additionally, this culturally sustaining education program incorporates insights from scholars like Drs. Gloria Ladson-Billings, Django Paris, and H. Samy Alim. Central to the curriculum is the Hispanic tradition of sobremesa, emphasizing connections and information sharing around the table after a meal. THK/LCA primarily aims to serve low-income Texans facing systemic barriers to food access. THK/LCA classes are held in community spaces like libraries, health clinics, and schools, and recruitment is conducted in collaboration with community organizations. The service population is defined as individuals or families with income less than 185% of the poverty line or who live in an area designated as low-income/low-access by USDA's Food Access Research Atlas. THK/LCA is a community-engaged, peer-facilitated, interactive 6-week cooking and nutrition class series that emphasizes the selection and preparation of fresh, nutritious, and economical foods in alignment with traditional foodways. Pre-, post-, and 3-month follow-up surveys were administered to obtain information on program completion, meals provided, changes in fruit and vegetable intake, nutrition knowledge, cooking skills, and home-cooked meal preparation. Counts and percentages were determined using Tableau data analysis software. Three hundred and sixty-five Texans participated in THK/LCA classes, with 196 participants completing all 6 classes in a series. The equivalent of 4,851 meals were provided to participants. Most participants reported increases in fruit and vegetable consumption (80%), nutrition knowledge (89%), cooking skills (86%), and cooking more meals at home (80%). THK/LCA has demonstrated success in improving access to fresh and nutritious foods among low-income people living in Texas. Next steps will include an evaluation of program expansion efforts. None [ABSTRACT FROM AUTHOR]

Introduction: Mexican-origin women in the U.S. living in colonias (new-destination Mexican-immigrant communities) along the Texas-Mexico border suffer from a high incidence of food insecurity and diet-related chronic disease. Understanding environmental factors that influence food-related behaviors among this population will be important to improving the well-being of colonia households. This article focuses on cultural repertoires that enable food choice and the everyday uses of technology in food-related practice by Mexican-immigrant women in colonia households under conditions of material hardship. Findings are presented within a conceptual framework informed by concepts drawn from sociological accounts of technology, food choice, culture, and material hardship. Methods: Field notes were provided by teams of promotora-researchers (indigenous community health workers) and public-health professionals trained as participant observers. They conducted observations on three separate occasions (two half-days during the week and one weekend day) within eight family residences located in colonias near the towns of Alton and San Carlos, Texas. English observations were coded inductively and early observations stressed the importance of technology and material hardship in food-related behavior. These observations were further explored and coded using the qualitative data package Atlas.ti. Results: Technology included kitchen implements used in standard and adapted configurations and household infrastructure. Residents employed tools across a range of food-related activities identified as forms of food acquisition, storage, preparation, serving, feeding and eating, cleaning, and waste processing. Material hardships included the quality, quantity, acceptability, and uncertainty dimensions of food insecurity, and insufficient consumption of housing, clothing and medical care. Cultural repertoires for coping with material hardship included reliance on inexpensive staple foods and dishes, and conventional and innovative technological practices. These repertoires expressed the creative agency of women colonia residents. Food-related practices were constrained by climate, animal and insect pests, women's gender roles, limitations in neighborhood and household infrastructure, and economic and material resources. Conclusions: This research points to the importance of socioeconomic and structural factors such as gender roles, economic poverty and material hardship as constraints on food choice and food-related behavior. In turn, it emphasizes the innovative practices employed by women residents of colonias to prepare meals under these constraints. [ABSTRACT FROM AUTHOR]

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women. [ABSTRACT FROM AUTHOR]

The availability of an adequate household food supply is critical for the older population. There is little work that has examined food security and the influence of nativity on food security among older Mexican Americans living along the Texas-Mexico border. Using data from 140 older women (age ≥ 50 y) who participated in the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA), we examined demographic characteristics, health characteristics, food access and mobility, federal and community food and nutrition assistance programs, quality of food environment, food security, eating behaviors, and alternative food sources. 77% of participants experienced food insecurity, with 68% experiencing very low food security. Very low food security was associated with being born in Mexico, adjusting for household income and food assistance program participation. This article provides compelling evidence for enhanced research efforts that will better understand coping strategies and the use of food and nutrition assistance programs for reducing hardship associated with very low food security among older U.S.- and Mexico-born Mexican American women. [ABSTRACT FROM AUTHOR]

This study examined the association of compositional measures of collective social functioning, composed of community and familial social capital and perceived personal disparity, with food security among older (aged 50-59 y) and senior (aged ≥ 60 y) adult residents of the largely rural Brazos Valley in Central Texas using data from the 2006 Brazos Valley Community Health Assessment (analytic N = 1059, 74% response rate). Among older adults and seniors, 18.6% reported food insecurity (5.5% often and 13.1% sometimes), defined as running out of food and not having money to buy more. Low community social capital was reported by 22.4% of participants, and 30.8% indicated they were single, widowed, or divorced, an indicator of limited familial social capital. A robust multinomial regression model found the odds of reporting greater food insecurity increased for individuals who were women, African American, residents of a household with a low or poverty-level income, individuals who perceived themselves to be worse off than others within their community, and those who had low social capital. The odds of being food insecure decreased for older respondents, partnered respondents and persons with more education (pseudo r2 = 0.27, p < 0.0000). Compositional level measures of collective social functioning are important associates of food insecurity among older adults and seniors, regardless of severity. [ABSTRACT FROM AUTHOR]

Abstract: There is a paucity of studies acknowledging the existence of alternative food sources, and factors associated with food purchasing from three common alternative sources: vendedores (mobile food vendors), pulgas (flea markets), and vecinos/amigos (neighbors/friends). This analysis aims to examine the use of alternative food sources by Mexican-origin women from Texas-border colonias and determine factors associated with their use. The design was cross-sectional. Promotora-researchers (promotoras de salud trained in research methods) recruited 610 Mexican-origin women from 44 colonias and conducted in-person surveys. Surveys included participant characteristics and measures of food environment use and household food security. Statistical analyses included separate logistic regressions, modeled for food purchase from mobile food vendors, pulgas, or neighbors/friends. Child food insecurity was associated with purchasing food from mobile food vendors, while household food security was associated with using pulgas or neighbors/friends. School nutrition program participants were more likely to live in households that depend on alternative food sources. Efforts to increase healthful food consumption such as fruits and vegetables should acknowledge all potential food sources (traditional, convenience, nontraditional, and alternative), especially those preferred by colonia residents. Current findings support the conceptual broadening of the retail food environment, and the importance of linking use with spatial access (proximity) to more accurately depict access to food sources. [Copyright &y& Elsevier]

The U.S. Latino/a population is a large and fast-growing population in the country, which has experienced a disproportionate burden of food insecurity compared with the national average. There is a need to understand how Latino/a parents use different strategies to maintain food security. To understand the food security management and coping strategies of Latino/a households through in-depth interviews. A qualitative study with remote in-depth interviews, conducted in Texas (Oct. 2021-Aug. 2022), with Latino/a parents and caregivers living in Central Texas. Trained interviewers used an interview guide (≈75 minutes/interview). Data came from a multi-site study with cognitive and exploratory interviews related to food insecurity. Interviews were recorded and transcribed verbatim. Data analysis was completed through transcript review, summary sheets, coding, and peer-debriefing. A codebook was developed based on prior experience, the literature, and rounds of initial coding and discussion. The goal of analysis was to identify common patterns and develop themes and subthemes. Twenty Latino/a parents and caregivers completed interviews (16 female and 4 male participants). Most participants were Mexican heritage and spoke primarily English (3 Spanish speakers). Overall, participants described similar food security management and coping strategies, despite differences in lifecourse experiences or household characteristics. Inflation and rising food prices, the COVID-19 pandemic, and global events affected food choices and access to food assistance. Strategies included limiting or rationing food, skipping meals, value food shopping strategies, food assistance from food pantries/banks, churches, and federal food assistance programs, such as SNAP or WIC. Some participants described challenges accessing federal food assistance programs, such as eligibility restrictions. External factors exacerbated food insecurity, but community resources, like food banks/food pantries, and federal programs, like SNAP or WIC, were important to maintain food security. Given reauthorization of important nutrition policies, this study contributes additional evidence for strengthening nutrition and food assistance programs. Future work is needed to understand how management or coping strategies for Latino/a households. USDA This research is supported by the Food Security 25 Small Grant Program, funded through U.S. Department of Agriculture Economic Research Service in collaboration with Tufts University and University of Missouri (59-4000-0-0067, subaward #AG9033). This research is also supported by U.S. Department of Agriculture National Institute of Food and Agriculture under award number 2021-77040-34877 (Nutrition LEADers Learning Community). [ABSTRACT FROM AUTHOR]

Fathers are potential leaders of healthy behavior changes in their families. Culturally tailored programs are needed to support behavior changes within families, including Latino families; however, there have been few father-focused nutrition programs for Latino families. This study evaluated the immediate effects of &iexcl;Haz Espacio Para Papi! (Make Room for Daddy!; HEPP), a six-week, father-focused, family-centered program focused on nutrition and physical activity near the Texas-Mexico border. A modified stepped-wedge study design included a treatment group for the HEPP pilot and a wait-listed control group. Pre/post-tests included instant skin carotenoid scores, the self-reported dietary intake of fruits and vegetables (FV), and healthy dietary behavior scores (HDBSs). A 2 × 2 mixed analysis of variance evaluated changes in outcomes across time and between groups for 42 fathers with pre/post-test measures. There were no statistically significant changes in fathers' VM scores and FV intake across time or between groups. Fathers' HDBSs increased across time ( p ≤ 0.01, 95% CI [0.23, 1.38]). Age, educational attainment, and the number of children living in the household did not have a significant effect on the program outcomes ( p > 0.05). The HEPP program may guide the design of future father-focused nutrition interventions aimed at dietary behavior changes.

Systemic and social factors, like poverty and food insecurity, negatively influence fruit and vegetable (FV) intake and body mass index (BMI) among Latino/a children. Behavioral programs are needed to support children's nutrition. This study examined program effects on FV intake and BMI outcomes for Mexican-heritage children (9-11 years). The program used a modified stepped-wedge design in the Lower Rio Grande Valley of Texas (2019 and 2020). Promotoras led experiential nutrition education sessions and collected height, weight, and instant skin carotenoid scores (biomarker for FV intake) at pre-test (baseline), post-test (6 weeks), and maintenance (3-4 months after post-test). Mean changes and group differences in skin carotenoid scores, BMI z-scores and percentiles were obtained from analyses of variance. Linear mixed-effects models were used to determine overall program effects. Mexican-heritage children were enrolled (n = 57 and 52.6% female). An overall decrease in skin carotenoid scores was observed at post-test (-15.1; 95% CI: -24.95, -5.33). While scores varied widely (range: 17-498), an increase of 14.8 ± 23.8 points occurred in one intervention group. Compared to the control period, greater reductions in BMI outcomes occurred during the program. These findings provide evidence for the use of strengths-based approaches in behavioral nutrition programs.

Fathers significantly influence family functioning, as coparents and partners, and must be part of family-based approaches to behavioral health interventions or programs. But little is known regarding how to support Latino fathers in health promotion within their family systems, specifically for Latino families living in border communities. Program development was embedded in a larger community-based grant and part of a longstanding academic-community collaboration. An interdisciplinary research team applied theories related to health behavior, family systems, behavior change, and community engagement to develop a father-focused and family-centered behavioral program for Mexican-heritage fathers and children living near the Texas-Mexico border to support changes in nutrition and physical activity at the individual and family levels. Promotoras de salud (trained community health workers) delivered the program through group sessions, check-in calls, and at-home activities. Group session activities were designed to engage family triads and dyads using experiential education related to nutrition and physical activity, like cooking lessons and active play, over a six-week period. Future research can use the program approach and curricula as a roadmap for designing context-specific and culturally-relevant programs for Latino families. Additional research is needed to explore how approaches like this can support families and their health goals.

Promotoras are trusted members of underserved, at-risk Hispanic communities experiencing social and health inequities. As promotora-researchers, promotoras have the unique ability and opportunity not only to provide outreach and education but also to be actively engaged in conducting research in their communities and serve as a cultural bridge between the community and researchers. In this article, we present a case study of personal and collective empowerment of six promotora-researchers who participated in seven community-based participatory research projects. Data sources included debriefing interviews with the promotora-researchers, milestone tracking and documentation completed during and after each study, and observations by the principal investigator and project managers regarding the role of the promotora-researchers in these studies. We qualitatively analyzed the data to identify the processes and decisions that were developed and implemented in a series of projects, which resulted in promotora-researcher empowerment. We found that active engagement empowered promotora-researchers personally and collectively in all phases of the research study. Common elements that contributed to the empowerment of promotora-researchers were valuing promotora-researchers' input, enabling promotora-researchers to acquire and utilize new skills, and allowing promotora-researchers to serve as both researchers and traditional promotoras. Together, these elements enabled them to more fully participate in research projects, while allowing them to identify and address needs within their own communities.

Background: Food insecurity among Mexican-origin and Hispanic households is a critical nutritional health issue of national importance. At the same time, nutrition-related health conditions, such as obesity and type 2 diabetes, are increasing in Mexican-origin youth. Risk factors for obesity and type 2 diabetes are more common in Mexican-origin children and include increased intakes of energy-dense and nutrient-poor foods. This study assessed the relationship between children's experience of food insecurity and nutrient intake from food and beverages among Mexican-origin children (age 6-11 y) who resided in Texas border colonias., Methods: Baseline data from 50 Mexican-origin children were collected in the home by trained promotora-researchers. All survey (demographics and nine-item child food security measure) and 24-hour dietary recall data were collected in Spanish. Dietary data were collected in person on three occasions using a multiple-pass approach; nutrient intakes were calculated with NDS-R software. Separate multiple regression models were individually fitted for total energy, protein, dietary fiber, calcium, vitamin D, potassium, sodium, Vitamin C, and percentage of calories from fat and added sugars., Results: Thirty-two children (64%) reported low or very low food security. Few children met the recommendations for calcium, dietary fiber, and sodium; and none for potassium or vitamin D. Weekend intake was lower than weekday for calcium, vitamin D, potassium, and vitamin C; and higher for percent of calories from fat. Three-day average dietary intakes of total calories, protein, and percent of calories from added sugars increased with declining food security status. Very low food security was associated with greater intakes of total energy, calcium, and percentage of calories from fat and added sugar., Conclusions: This paper not only emphasizes the alarming rates of food insecurity for this Hispanic subgroup, but describes the associations for food insecurity and diet among this sample of Mexican-origin children. Child-reported food insecurity situations could serve as a screen for nutrition problems in children. Further, the National School Lunch and School Breakfast Programs, which play a major beneficial role in children's weekday intakes, may not be enough to keep pace with the nutritional needs of low and very low food secure Mexican-origin children.

Background: Trends of increasing obesity are especially pronounced among Mexican-origin women. There is little understanding of dietary patterns among U.S.- and Mexico-born Mexican-origin individuals residing in new-destination immigrant communities in the United States, especially behaviors related to obesity, such as consumption of sugar-sweetened beverages (SSB) and fast-food meals (FFM)., Methods: The study used survey data of 599 adult Mexican-origin women from the 610 women who completed the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA), which was completed in person by trained promotora-researchers in 44 colonias near the Texas border towns of Progreso and La Feria. Data included demographic characteristics (age, education, nativity or country of birth, household income, household composition, and employment status), access to transportation, self-reported height and weight, food and nutrition assistance program participation, and consumption of SSB and FFM. Descriptive statistics were calculated by nativity (U.S.-born vs. Mexico-born); multivariable linear regression models were estimated for correlates of consumption of SSB and FFM., Results: There are three major findings related to nativity. First, U.S.-born women consumed more SSB and FFM than Mexican-born counterparts in the same areas of colonias. Second, in the combined sample and controlling for other population characteristics, being born in Mexico was independently associated with FFM (fewer FFM), but not with SSB. Third, in analyses stratified by nativity, FFM and SSB were associated with each other among both nativity groups. Among Mexico-born women only, age, presence of a child, or being a lone parent was significantly associated with SSB; full-time employment, being a lone parent, and SSB consumption were each independently associated with increased frequency of FFM., Conclusions: Our analyses revealed differences in prevalence and correlates of SSB and FFM based on country of birth. Nativity, as a proxy for acculturation, may indicate the extent that immigrants have adopted behaviors from their new environment. However, nativity could also indicate limited accessibility to resources such as food/nutrition assistance programs, transportation, and proper documentation. Additionally, future research should focus on expanding our understanding of the meaning of nativity among individuals who share common contextual factors, but may have different life course experiences and resources needed to transition into a new place. Additional measures should be considered such as educational and occupational background, migration history, documentation status, and dietary acculturation, which may better explain heterogeneity within Hispanic subgroups.

Objective: The objective of this study is to examine the relationship between residential exposure to fast-food entrées, using two measures of potential spatial access: proximity (distance to the nearest location) and coverage (number of different locations), and weekly consumption of fast-food meals., Methods: Traditional fast-food restaurants and non-traditional fast-food outlets, such as convenience stores, supermarkets, and grocery stores, from the 2006 Brazos Valley Food Environment Project were linked with individual participants (n = 1409) who completed the nutrition module in the 2006 Brazos Valley Community Health Assessment., Results: Increased age, poverty, increased distance to the nearest fast food, and increased number of different traditional fast-food restaurants, non-traditional fast-food outlets, or fast-food opportunities were associated with less frequent weekly consumption of fast-food meals. The interaction of gender and proximity (distance) or coverage (number) indicated that the association of proximity to or coverage of fast-food locations on fast-food consumption was greater among women and opposite of independent effects., Conclusions: Results provide impetus for identifying and understanding the complex relationship between access to all fast-food opportunities, rather than to traditional fast-food restaurants alone, and fast-food consumption. The results indicate the importance of further examining the complex interaction of gender and distance in rural areas and particularly in fast-food consumption. Furthermore, this study emphasizes the need for health promotion and policy efforts to consider all sources of fast-food as part of promoting healthful food choices.

Background: Individuals and families are relying more on food prepared outside the home as a source for at-home and away-from-home consumption. Restricting the estimation of fast-food access to fast-food restaurants alone may underestimate potential spatial access to fast food., Methods: The study used data from the 2006 Brazos Valley Food Environment Project (BVFEP) and the 2000 U.S. Census Summary File 3 for six rural counties in the Texas Brazos Valley region. BVFEP ground-truthed data included identification and geocoding of all fast-food restaurants, convenience stores, supermarkets, and grocery stores in study area and on-site assessment of the availability and variety of fast-food lunch/dinner entrées and side dishes. Network distance was calculated from the population-weighted centroid of each census block group to all retail locations that marketed fast food (n = 205 fast-food opportunities)., Results: Spatial access to fast-food opportunities (FFO) was significantly better than to traditional fast-food restaurants (FFR). The median distance to the nearest FFO was 2.7 miles, compared with 4.5 miles to the nearest FFR. Residents of high deprivation neighborhoods had better spatial access to a variety of healthier fast-food entrée and side dish options than residents of low deprivation neighborhoods., Conclusions: Our analyses revealed that identifying fast-food restaurants as the sole source of fast-food entrées and side dishes underestimated neighborhood exposure to fast food, in terms of both neighborhood proximity and coverage. Potential interventions must consider all retail opportunities for fast food, and not just traditional FFR.