Development and impact of a Stage of Change bilingual nutrition education program for Hispanics
Date
1997
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Abstract
A nutrition education program, entitled La Cocina Saludable - The Healthy Kitchen, was designed based on the Stage of Change Model for Behavior Change and implemented in 10 counties in southern Colorado. The objectives were to improve the nutrition related knowledge, skills, and behaviors that lead to healthy lifestyles in a low-income Hispanic and migrant farmworker population. The content of the program included nutrition information designed to help mothers of preschool children provide for their children's nutritional needs. Specifically, the content areas included 1) Make It Healthy - nutrition principles including the Food Guide Pyramid; 2) Make it Fun - making food fun for children using color, texture, size, and shape; 3) Make A Change - modifying recipes and meals to lower fat, lower salt, lower sugar, and increase fiber; 4) Make it Safe - food safety principles; and 5) Make A Plan - budgeting and shopping tips to help stretch food resources. This population presents many obstacles for nutrition educators including limited resources, child care, transportation, time, language, culture, literacy, education, health beliefs, and in some cases, the transient nature of the population. Previous studies suggest that low-income Hispanics often show low intakes of vitamins A and C, calcium, iron, and protein. It follows that they show high rates of diabetes, obesity, infections, and enteric diseases. This program attempted to overcome these barriers by incorporating the use of a flexible program format carried out by abuela (Hispanic grandmother) educators using appropriate processes described in the Stages of Change Model for Behavior Change. The Stage of Change Model categorizes changing individuals into five stages: precontemplation, contemplation, preparation, action, and maintenance. It is suggested that within each stage, individuals emphasize specific processes that help to move them to the next stage. The program design and materials were developed by thoughtful incorporation of these processes. The program was evaluated using a knowledge and skills pre-test, post-test, and six month follow-up survey which included selected elements from WIC and EFNEP program evaluations. An instrument for measuring movement through the five stages was also developed. Final results of the program's evaluation suggest that this type of program based on the Stages of Change Model and using abuela educators as peer educators is effective in changing selected nutrition related knowledge, skills, and behaviors leading to healthy lifestyles. Administration of similar programs should be thoughtfully planned and implemented. Additionally, development and use of a Stage of Change assessment tool suggests key considerations when attempting to measure stages relative to nutrition behaviors for this population.
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Subject
Hispanic Americans -- Nutrition
Nutrition -- Social aspects