摘要：Objectives. We evaluated the effectiveness of a community-based healthy lifestyle intervention in improving dietary behaviors of pregnant Latinas from 2004 to 2006 in Detroit, Michigan. Methods. The 11-week, culturally tailored, Spanish-language Healthy Mothers on the Move (MOMs) intervention offered home visits, group classes, related activities, and social support from trained community health workers (CHWs) and peers. Dietary behaviors were measured by food frequency questionnaire. Linear mixed models estimated pre- and post-intervention changes, within and between MOMs intervention and minimal intervention (MI) groups. Results. MOMs (n = 139) and MI (n = 139) participants had similar baseline characteristics and dietary intake. Post-intervention, MOMs participants showed significant improvement in all dietary behaviors, except fruit and fiber consumption. Compared with MI participants, MOMs participants had significantly decreased consumption of added sugar ( P = .05), total fat ( P < .05), saturated fat ( P < .01), percentage of daily calories from saturated fat ( P < .001), solid fats and added sugars ( P < .001), and had increased vegetable consumption ( P < .001). Their increase in fiber consumption ( P < .05) was significant relative to MI participants’ decrease in fiber intake. Conclusions. We confirmed the hypothesis that a community-planned, CHW-led healthy lifestyle intervention could improve dietary behaviors of low-income Latina women during pregnancy. Obesity, gestational diabetes, and type 2 diabetes are prevalent among Latina women of childbearing age in the United States. 1–6 Dietary intake, particularly low consumption of vegetables and fruits and high consumption of added sugars and solid fats, is associated with these conditions. 7–13 In the Diabetes Prevention Program randomized controlled trial, an intensive healthy lifestyle intervention that helped participants develop healthy diet and exercise patterns reduced the risk of developing type 2 diabetes among nonpregnant women with impaired glucose tolerance by half, including those with and without a history of gestational diabetes. 14 Pregnancy may be an optimum period for interventions to improve dietary behaviors 10,15,16 that have consequences for both maternal and child health. 11,17–20 Following the success of the Diabetes Prevention Program, it is important to assess whether community-based healthy lifestyle interventions can reduce diabetes risk factors in pregnant women. 18 Nonetheless, few randomized controlled studies have included dietary outcomes for pregnant women. 21,22 Only 1 pilot study was conducted in pregnant Latinas. 23 To address this gap, a community-academic partnership used community-based participatory research (CBPR) processes to develop and implement Healthy Mothers on the Move (MOMs), a community health worker (CHW)-led healthy lifestyle intervention tailored to the needs and strengths of pregnant Latinas in Detroit, Michigan. 24–26 Healthy MOMs aimed to demonstrate the effectiveness of this intervention to reduce behavioral and clinical risk factors for type 2 diabetes in pregnant and postpartum Latinas. We examined the hypothesis that women randomly assigned to the MOMs intervention group would significantly decrease their intake of added sugars, total fat and saturated fat, and significantly increase their intake of fruit, vegetables and fiber, compared with women assigned to the minimal intervention (MI) control group during pregnancy.
