Consumption of More Ideal Food Options (COMIDA: Consumo de Opciones Más Ideales De Alimentos)

Part of paid clinical trials in New York, New York.

Sponsor
Memorial Sloan Kettering Cancer Center
Study ID
NCT03851458
Phase
PHASE2
Status
Enrolling By Invitation

Conditions

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Accepted

Interventions

  • Initial in-person individual diet and exercise counseling (N vs. Y) — BEHAVIORAL
    Individual counseling utilizing MI has been effective in promoting behavioral change.18 A SANOS interventionist (MRNY promotora) will deliver a 45-60 minute counseling session, utilizing MI techniques, on diet and exercise, and how to stretch one's food dollars (see description of 10 modules described above under COMIDA Pilot). The promotora will evaluate the participant's diet based on the 24-hour dietary recall132 conducted at intake (see below), will compare diet composition to the USDA's MyPlate guidelines, and will then personalize education to address identified knowledge gaps and unhealthy food choices. Promotoras will focus on goal-setting, problem solving, selfefficacy enhancements, selfmonitoring skills (i.e., participants will be taught how to monitor their diet, weight, and physical activity (PA), with simple pencil-and-paper logs or with 'Self-monitoring tools' if randomized to also receive that component), and modeling of healthy behaviors.
  • Thrice weekly diet and exercise text messages (N vs. Y) — BEHAVIORAL
    Text message interventions have been demonstrated to be effective in increasing self-efficacy, weight loss, and PA.65-67 Participants will receive thrice weekly healthy eating, PA, and health care access text message tips. Links to additional information and videos will also be sent via text (e.g. local farmers markets, healthy recipes, free exercise classes, workout videos, video demonstrations of how to prepare healthy meals, etc.). Texts were developed and piloted in the COMIDA Pilot, are designed to promote goal-setting, problem-solving, self-monitoring, modeling, and self-efficacy, and will be further refined during the formative research phase (see below). Texts will be sent via Mosio Text Messaging Solutions. Messages will be concise, as longer messages have shown no demonstrable impact. Based on each participant's status at intake, tailored text messages will also encourage regular follow-up with PCPs. Text messages will be interactive.
  • Weekly telephone support (N vs. Y) — BEHAVIORAL
    Several lifestyle interventions including Hispanics have successfully incorporated telephone support.134-138 Weekly telephone support (or more frequently if requested) will be delivered by the promotoras throughout the 6-month intervention. Frequent and prolonged contact in behavioral interventions is more effective than single sessions; most interventions leading to diet or PA changes persisting for \>12 months have follow-up contact sessions for at least 4 months.18 Greater numbers of follow-up sessions facilitate success of behavior change, and initial behavior change can decrease with decreased contact.18,139 Telephone sessions (10-15 minutes) will use MI principles, will focus on goal-setting, problem solving, reviewing/integrating new diet/PA knowledge/skills (including self-monitoring) into individuals' daily routines, self-efficacy enhancements, encouraging participants to seek opportunities for modeling and encouraging regular follow-up with PCPs.
  • Self-monitoring tools (N vs. Y) (for diet and weight) — BEHAVIORAL
    Self-monitoring is an important component in achieving behavioral change.18 Participants will be given a SANOS food diary (adapted for and pilot-tested at the VDS in our pilot work) and a digital scale. As part of VDS Mobile usual care, all participants will receive a pedometer to assess exercise behavior (secondary outcome), so additional self-monitoring tools for PA will not be included in this component.

Study Details

The Mexican Consulate runs a Ventanilla de Salud (VDS) (Health Window) program in fifty locations nationwide. The VDS provides an opportunity to provide health services to members of the Mexican community. Some of the concerns previously identified during the work at the VDS were that some individuals did not always get enough to eat, or do not always have enough money for food. This sometimes leads to unhealthy food choices-- buying and preparing foods that are inexpensive but really not good for the particpant. The investigators would like to conduct focus group to help make changes to a new diet and exercise program at the VDS called SANOS which stands for SAlud y Nutrición para todOS. SANOS aims to provide information for living a healthier lifestyle including on how to eat healthy on a small budget and how to become more physically active. The hope is that learning to eat healthy without spending a lot of money and to find simple ways to increase physical activity (like walking) will be a first step in reducing obesity rates within the Mexican community that have led to increased risks for cancer, cardiovascular disease, and diabetes. Participants who reached 6-month follow-up during the COVID-19 pandemic, may be outside of the 12-month window post 6-month follow-up, and have not been able to complete HgbA1c and cholesterol measures will be invited to complete these measures in person at the VDS.

Key Dates

Start date
May 5, 2015
Status verified
Jun 2026
Primary completion
May 31, 2027
Completion
May 31, 2027

Study Design

Enrollment
1,785 participants (estimated)
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH

Arms

  • Experimental: Consumo de Opciones Mas Ideales De Alimento (COMIDA)
    Participants will be placed in either individual or group interventions by convenience. Recruitment will be consecutive and participants will be placed in either intervention depending on what resource is available on a given day at the VDS, individual counselor or a group educator.
  • Experimental: SANOS
    Conducting SANOS Focus Groups. We will conduct 3-5 focus groups (in Spanish) with 6-10 participants each, until saturation. Bilingual study staff will approach individuals visiting the VDS and VDS Mobile for potential participation. A brief screening questionnaire will be administered, and a BMI assessment conducted, to ascertain eligibility. Focus groups will be scheduled at the VDS Mobile unit at times convenient to participants. Participants will be verbally consented in Spanish, and will be apprised that their participation is purely voluntary and that their names will not be included in the final narrative. The 6-month follow-up and my plate dietary surveys can be done over phone. Study staff will access step counts (or obtain it through phone via the pedometer manual provided to the participant) and upload data onto the REDCap tracking tool. Staff may ask participants to report step counts captured by their personal devices (i.e., phone or smartwatch).
  • Experimental: ROADmAP schema
    Participants will be randomly assigned to one of eight study groups which will be one or a combination of 4 conditions: (1) in person individualized diet and exercise counseling (2) diet and exercise text messages (3) weekly telephone support and (4) self-monitoring tools for diet and weight. For the first part of the study, Survey, approximately 64 drivers and 36 management staff will take pate in the feedback questionnaire. For the second part of the study, Interview, approximately 8 drivers and 12 management staff may be invited to take part in an interview via phone, in person, or teleconference (Zoom).

Primary Outcome Measure

self-reported measures on dietary intake [ Time Frame: 1 year ]

Locations (1)

FacilityCityStateZIPSite coordinators
Mexican Consulate's Ventanilla de Salud (VDS)New YorkNew York10016-

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