Changes in health behaviors and self-rated health of participants in Meta Salud: a primary prevention intervention of NCD in Mexico

Abstract

Background: Meta Salud was a community health worker-facilitated intervention for the prevention of noncommunicable diseases in Northern Mexico.

Objectives: This analysis examined changes in perceived health, eating habits, and physical activity immediately and 3 months after the intervention. The impact on the resulting behavioral and psychological factors are reported.

Methods: This was a nonrandomized intervention study with 1 baseline and 2 post-intervention follow-ups. Outcome evaluation consisted of anthropometric measurements, laboratory tests, and a lifestyle questionnaire.

Results: The most consistent patterns were increases in metabolic equivalent of task values expended per day from baseline to post-intervention (difference = 996; 95% confidence interval [CI]: 81 to 1,912) and to 3-month follow-up (difference = 1,073; 95% CI: 119 to 2,028); greater likelihood of meeting Centers for Disease Control and Prevention daily exercise recommendations, with an increase from 49% to 60% at post-intervention (OR: 1.6, 95% CI: 1.0 to 2.4) and 63% at follow-up (OR: 1.7, 95% CI: 1.7 to 2.7); lesser likelihood for consuming whole milk, from 38% to 59% (OR: 2.9, 95% CI: 1.8 to 4.7); fewer daily servings of packaged foods, from 0.72 to 0.57 (difference = -0.16; 95% CI: -0.28 to -0.03); fewer days of poor mental health, from 9.3 to 5.8 (difference = -3.4; 95% CI: -5.1 to -1.7); and greater likelihood for reporting good self-rated health, from 41% to 54% post-intervention (OR: 2.1, 95% CI: 1.3 to 3.6) and 57% at follow-up (OR: 2.5, 95% CI: 1.5 to 4.4). Changes in other outcomes, although in the expected direction of association, were not statistically significant.

Conclusions: The study identified important strategies for making feasible dietary changes in the consumption of whole milk, sugary drinks, and packaged foods, yet there is still a need to identify strategies for improving consumption of healthy foods. There was stronger evidence for ways of improving physical activity as opposed to other outcome measures. Overall, it highlights the importance of behavioral and psychosocial factors as key intervention targets in preventing noncommunicable diseases in low- and middle-income countries.