Trial Information

Improving Health Habits in Impoverished Populations

Poor diet, physical inactivity, and sedentary behaviors among low-income, minority
populations have been linked to greater risk of chronic health conditions such as
overweight/obesity, cardiovascular disease, and type 2 diabetes. Low-income clinics that
serve these populations often represent an untapped opportunity for health promotion in
impoverished individuals. Few studies have examined the feasibility of using brief physician
advice and multi-level, clinic-based interventions to change poor dietary habits, physical
inactivity, and sedentary lifestyle behaviors among these culturally diverse populations
that comprise the clinic population. This exploratory project proposes to address this
scientific gap by introducing and piloting a Self-Care Stimulating Disease Prevention
Program (SCSDPP) to address poor dietary habits, physical inactivity, and sedentary
lifestyle behaviors among low income, uninsured patient populations (primarily Latinos)
served by the community clinics of the Venice Family Clinic (VFC) health center in Los
Angeles County. The program will include the development of 1) a simple-to-use patient
Health Priority Assessment (HPA) tool designed to assess patient preferences for behavior
change; 2) a standard protocol for physicians to provide brief health advice using
motivation interviewing (< 2 minutes per visit); 3) a protocol for distributing self-help
aids for patient use (e.g., pedometer, exercise videos); and 4) a series of monthly
follow-up counseling sessions by lay health educators (e.g., promotores) to help patients
address their lifestyle change priorities over time. We will conduct a randomized controlled
pilot of the SCSDPP in approximately 100 patient cases at two community health clinics
within the VFC health center system. The pilot will utilize precise outcome measures,
including commonly-accepted biomarkers (e.g., HgbA1c, fasting blood glucose) and
psychometrically-validated measures of process and health status, to accurately assess the
magnitude of changes in diet and physical activity among patients over a 12-month
observation period. The feasibility of integrating the SCSDPP into the community health
clinic setting will be evaluated, and is the primary aim of this project. The results will
inform efforts to plan a larger, successor study. Relevance to Public Health: this study
evaluates a clinic-based brief intervention to help prevent overweight/obesity, a public
health problem that has been linked to the development of the metabolic syndrome and other
precursors of diabetes.