Mujeres Fuertes y Corazones Saludables, a Culturally Tailored Physical Activity and Nutrition Program for Rural Latinas: Findings from a Pilot Study.

In the United States, Latino adults, compared with non-Hispanic white adults, are less likely to meet physical activity and dietary recommendations, and have higher rates of obesity. There is an urgent need for culturally adapted health promotion programs that meet the needs of the growing Latino population in the United States. We systematically adapted StrongWomen-Healthy Hearts, an evidence-based physical activity and nutrition program, for rural Latinas. This paper reports results from a pilot study of the adapted program. We used mixed methods to assess the feasibility and efficacy of the adapted program, Mujeres Fuertes y Corazones Saludables, in a nonprofit community organization serving rural Latinos. The intervention consisted of sixty-minute classes held twice weekly for 12 weeks and included 30 minutes of physical activity and 30 minutes of nutrition education. To assess efficacy, we used a one-group, pre⁻post design with overweight/obese, sedentary, middle-aged or older, Spanish-speaking rural Latinas (n = 15). Outcome measures included weight, height, body mass index (BMI), waist circumference, cardiorespiratory fitness, physical activity, dietary behavior, and self-efficacy for diet and physical activity. Process outcomes included attendance, end of class surveys, mid-program evaluation survey, and a post-program focus group. We calculated means and standard deviations, paproired t-tests, and Cohen's D effect size. Qualitative data were analyzed using qualitative description. Significant changes pre- to post-program included weight (-1.5 kg; p = 0.009), BMI (-0.6; p = 0.005), waist circumference (-3.0 cm; p = 0.008), 6-minute walk test (69.7 m; p < 0.001), frequency of sugar-added drink consumption (-0.7 servings; p = 0.008), fruit and vegetable intake (1.3 servings; p = 0.035), and physical activity self-efficacy (0.9 points; p = 0.022). Participants found the program motivating and enjoyable, and on average participants attended 62% of classes and fidelity was maintained. This pilot study suggests that this culturally adapted physical activity and nutrition program for rural Latinas shows promise in improving physical activity, diet, and obesity.

Mujeres Fuertes y Corazones Saludables: adaptation of the StrongWomen -healthy hearts program for rural Latinas using an intervention mapping approach.

OBJECTIVE: To describe our use of intervention mapping as a systematic method to adapt an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas. METHODS: An intervention mapping process involving six steps guided the adaptation of an evidence based physical activity and nutrition program, using a community-based participatory research approach. We partnered with a community advisory board of rural Latinas throughout the adaptation process. RESULTS: A needs assessment and logic models were used to ascertain which program was the best fit for adaptation. Once identified, we collaborated with one of the developers of the original program (StrongWomen - Healthy Hearts) during the adaptation process. First, essential theoretical methods and program elements were identified, and additional elements were added or adapted. Next, we reviewed and made changes to reflect the community and cultural context of the practical applications, intervention strategies, program curriculum, materials, and participant information. Finally, we planned for the implementation and evaluation of the adapted program, Mujeres Fuertes y Corazones Saludables, within the context of the rural community. A pilot study will be conducted with overweight, sedentary, middle-aged, Spanish-speaking Latinas. Outcome measures will assess change in weight, physical fitness, physical activity, and nutrition behavior. CONCLUSIONS: The intervention mapping process was feasible and provided a systematic approach to balance fit and fidelity in the adaptation of an evidence-based program. Collaboration with community members ensured that the components of the curriculum that were adapted were culturally appropriate and relevant within the local community context.

Soil-geomorphic heterogeneity governs patchy vegetation dynamics at an arid ecotone.

Soil properties are well known to affect vegetation, but the role of soil heterogeneity in the patterning of vegetation dynamics is poorly documented. We asked whether the location of an ecotone separating grass-dominated and sparsely vegetated areas reflected only historical variation in degradation or was related to variation in inherent soil properties. We then asked whether changes in the cover and spatial organization of vegetated and bare patches assessed using repeat aerial photography reflected self-organizing dynamics unrelated to soil variation or the stable patterning of soil variation. We found that the present-day ecotone was related to a shift from more weakly to more strongly developed soils. Parts of the ecotone were stable over a 60-year period, but shifts between bare and vegetated states, as well as persistently vegetated and bare states, occurred largely in small (<40 m2) patches throughout the study area. The probability that patches were presently vegetated or bare, as well as the probability that vegetation persisted and/or established over the 60-year period, was negatively related to surface calcium carbonate and positively related to subsurface clay content. Thus, only a fraction of the landscape was susceptible to vegetation change, and the sparsely vegetated area probably featured a higher frequency of susceptible soil patches. Patch dynamics and self-organizing processes can be constrained by subtle (and often unrecognized) soil heterogeneity.