Resources for Health: a Primary-care-based Diet and Physical Activity Intervention Targeting Urban Latinos with Multiple Chronic Conditions Queensland Cancer Fund

Objective: The Resources for Health trial evaluates a social-ecologically based lifestyle (physical activity and diet) intervention targeting low-income, largely Spanish-speaking patients with multiple chronic conditions. Design: A randomized controlled trial was conducted with 200 patients recruited from an urban community health center and assigned to intervention and usual care conditions. Intervention involved 2 face-to-face, self-management support and community linkage sessions with a health educator, 3 follow-up phone calls, and 3 tailored newsletters. Main Outcome Measures: Primary outcomes measured at 6-months were changes in dietary behavior and physical activity. Changes in multilevel support for healthy living were evaluated as a secondary outcome. Results: After adjustment for age, sex, language, and number of chronic conditions, significant intervention effects were observed for dietary behavior and multilevel support for healthy lifestyles but not for physical activity. Conclusion: The Resources for Health intervention provides an effective and practical model for improving health behavior among low-income, Spanish-speaking patients with multiple chronic conditions. There is widespread agreement that patient involvement in disease management (referred to as self-management or collabo-rative management) is required for control of chronic disease and for prevention of disease complications (Von Korff, Glasgow, & Sharpe, 2002; Wagner & Groves, 2002). For the majority of chronic conditions, this involves addressing multiple behavioral risk factors (i.e., physical activity, diet, smoking and alcohol), as well as monitoring and managing the signs of symptoms of disease , taking medications appropriately, maintaining regular contact with health care providers, and managing emotional and social The past two decades have witnessed a wealth of research demonstrating the efficacy of chronic disease self-management interventions & Curry, 1997). These interventions have most often focused on key lifestyle behaviors, and on medication adherence, and have targeted patients with a range of chronic conditions, with an emphasis on asthma, arthritis, and diabetes (Barlow, Wright, Sheasby, Turner, & Hainsworth, 2002). Despite the growing evidence base, some key gaps remain. The better part of this literature has focused on White, middle class samples, thus telling us little about how best to deliver chronic disease self-management interventions to low-income, ethnic minority and underserved patients, who bear the largest burden of disease and often have more than one chronic condition and multiple self-management behaviors that need to be addressed 041862 for its national program on Improving Chronic Illness Care (www .improvingchroniccare.org). We are grateful to the staff and patients of the Clinica Campesina Family Health Services for their support …