Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border

This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into “low exposure” (2–3 visits) and “high exposure” (4–5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53–0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9–265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65–2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10–1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelit

Scaling a Community-Wide Campaign Intervention to Manage Hypertension and Weight Loss

Public health impacts can be achieved when evidence-based interventions are implemented to those most in need. Too often implementation never or slowly occurs. The community-wide campaign intervention Tu Salud ¡Si Cuenta! has evidence of improving health outcomes related to chronic disease among low-income, Latinos. Using the RE-AIM Framework, this study examined if the scaled-up version of the intervention is associated with improvements in hypertension and obesity in 12 locations. Each element of the RE-AIM framework was examined. For Effectiveness, we examined outcomes overall and by implementing location. We used linear and logistic regression to assess if exposure in the intervention was associated with improvement in hypertension and weight loss. Participants were stratified into low exposure (2-3 outreach visits) vs. high exposure (4-5 outreach visits). Based on the RE-AIM Framework, the intervention reached its intended population of low-income Latinos, demonstrated effectiveness in improving hypertension and obesity, was adopted at a high level in all but one site, was implemented with fidelity to the intervention model with moderate success across locations, and showed high maintenance over time. For effectiveness specifically, we found that out of 5,019 participants, 2,508 (50%) had a baseline hypertensive blood pressure (BP) reading. Of the 2,508, 1,245 (49.9%) recovered to normal blood pressure or pre-hypertension stage by last follow-up. After adjusting for baseline BP and potential confounders in multivariable linear regression models, the high exposure group had significantly more reduction in systolic BP (adjusted mean difference in % change = -0.96; p = 0.002) and diastolic BP (adjusted mean difference in % change = -1.61; p \u3c 0.0001) compared to the low exposure group. After controlling for baseline weight and other confounders, the high exposure group had significantly greater decrease in weight compared to the low exposure group (adjusted mean difference in % change = -1.28; p \u3c 0.0001). Results from the multivariable logistic regression models indicated that compared to the low exposure group the high exposure group was more likely to achieve a clinically significant minimum 5% weight loss [adjusted odds ratio (OR) = 2.97; p \u3c 0.0001). This study contributes evidence that a Community-Wide Campaign model holds promise for addressing hypertension and obesity among low-income Latinos

The Baryonic Collapse Efficiency of Galaxy Groups in the RESOLVE and ECO Surveys

We examine the z = 0 group-integrated stellar and cold baryonic (stars + cold atomic gas) mass functions (group SMF and CBMF) and the baryonic collapse efficiency (group cold baryonic to dark matter halo mass ratio) using the RESOLVE and ECO survey galaxy group catalogs and a galform semi-analytic model (SAM) mock catalog. The group SMF and CBMF fall off more steeply at high masses and rise with a shallower low-mass slope than the theoretical halo mass function (HMF). The transition occurs at group-integrated cold baryonic mass M_coldbary ~ 10^11 Msun. The SAM, however, has significantly fewer groups at the transition mass ~ 10^11 Msun and a steeper low-mass slope than the data, suggesting that feedback is too weak in low-mass halos and conversely too strong near the transition mass. Using literature prescriptions to include hot halo gas and potential unobservable galaxy gas produces a group BMF with slope similar to the HMF even below the transition mass. Its normalization is lower by a factor of ~2, in agreement with estimates of warm-hot gas making up the remaining difference. We compute baryonic collapse efficiency with the halo mass calculated two ways, via halo abundance matching (HAM) and via dynamics (extended all the way to three-galaxy groups using stacking). Using HAM, we find that baryonic collapse efficiencies reach a flat maximum for groups across the halo mass range of M_halo ~ 10^11.4-12 Msun, which we label "nascent groups." Using dynamics, however, we find greater scatter in baryonic collapse efficiencies, likely indicating variation in group hot-to-cold baryon ratios. Similarly, we see higher scatter in baryonic collapse efficiencies in the SAM when using its true groups and their group halo masses as opposed to friends-of-friends groups and HAM masses

Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border

This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into “low exposure” (2–3 visits) and “high exposure” (4–5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53–0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9–265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65–2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10–1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelity