University of Illinois kinesiology and community health professor Andiara Schwingel's studies show that health-promotion programs may be more successful at reaching older Latinas in the U.S. if they incorporate the religious and spiritual values that tend to be important to these women. Shown with Schwingel, center, are her co-authors, left, doctoral student Patricia Gálvez and post-doctoral research fellow Emerson Sebastião. Alumna Deborah Linares also was a co-author on the studies. Credit: L. Brian Stauffer

A culturally sensitive lifestyle intervention showed promise at motivating Latinas living in the U.S. to eat better and exercise more by connecting healthy-living behaviors with the lives of saints and prominent religious figures, new studies found.

Several recent papers about the project, including a new study published in the Journal of Aging and Health, add to a growing body of research that indicates health interventions may have greater success promoting lifestyle changes among the nation's rapidly growing Latino population if the content is culturally sensitive, integrating the spiritual and family values that are central to these women's lives.

Kinesiology and community health professor Andiara Schwingel of the University of Illinois developed the program, called Abuelas en Acción (Grandmothers in Action). Geared toward Latinas ages 50 and older, Abuelas en Acción promotes physical activity, nutrition and stress management using the principles of several evidence-based behavioral change programs.

Promotoras, female community leaders familiar with local customs and traditions, administered the program. They received 18 hours of training to deliver the religious and the health education curricula, which included group discussions and hands-on activities, in six monthly workshops. In each workshop, Roman Catholic teachings connected a specific health behavior change with the life of a Catholic saint or prominent religious figure who exemplified that concept.

Schwingel, together with her research team, developed the religious curricula in collaboration with local community leaders from the Chicago neighborhood where the intervention was implemented.

Most of the women who completed Abuelas en Acción were overweight and had weight-related health problems such as heart disease, osteoarthritis and diabetes. More than 82 percent of participants were overweight or obese, 85 percent had at least one chronic health condition, and all of them had depressive symptoms, according to health assessments conducted by the researchers.

Encouraged to find creative ways to become more active, participants were given pedometers and told to aim for walking 10,000 steps a day. The percentage of women who put in at least 150 minutes of moderate or vigorous physical activity weekly increased significantly during the program. At the conclusion, nearly 87 percent of the women were considered physically active, according to a paper published in the Journal of Aging and Health. U. of I. doctoral researchers Patricia Gálvez, Deborah Linares and Emerson Sebastião were Schwingel's co-authors on that study.

Food assessments completed by the women who finished the program indicated they significantly improved their diets, increasing their consumption of fruits, vegetables and whole grains while decreasing their consumption of fried foods.

Participants' depressive symptoms also decreased significantly, and many women said they had developed a more positive outlook on life, the researchers found.

Using the lives of religious figures to explain concepts helped participants grasp the health information and created a holistic experience of spiritual and physical self-improvement that enhanced feelings of self-efficacy, Schwingel and Gálvez reported in a paper published recently in the Journal of Religion and Health.

"Putting religious content at the center of the program fostered a stronger relationship between Latinas and the program, contributing to higher levels of engagement and motivation," Schwingel said. "The religious content motivated the women to make healthier choices and reflect on their lifestyle."

The promotoras provided ongoing support and motivation for participants during the program's first six months. The experience was positive for the promotoras and participants alike, who reported that the program strengthened existing relationships and allowed new ones to form.

An invitation from local community leaders to participate increased the likelihood that women would enroll in Abuelas en Acción, affirming the high degree of influence that prominent individuals can have on the health of other people in their communities, the researchers wrote.

"Church-based health promotion has been shown to be key to reaching Latinos, a vulnerable population that is often hard for public health programs to reach. Many lack health insurance coverage and may need health programs the most," Schwingel said.

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More information: A. Schwingel et al, Using a Mixed-Methods RE-AIM Framework to Evaluate Community Health Programs for Older Latinas, Journal of Aging and Health (2016). A. Schwingel et al, Using a Mixed-Methods RE-AIM Framework to Evaluate Community Health Programs for Older Latinas,(2016). DOI: 10.1177/0898264316641075