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Browsing by Author "Cutshaw, Christina A."
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Item Depressive Symptoms and Health-Related Quality of Life Among Participants in the Pasos Adelante Chronic Disease Prevention and Control Program, Arizona, 2005-2008(Centers for Disease Control and Prevention, 2012) Cutshaw, Christina A.; Staten, Lisa K.; Reinschmidt, Kerstin M.; Davidson, Christopher; Roe, Denise J.Introduction Chronic diseases are the leading causes of death in the United States and have been associated with depressive symptoms and poor health-related quality of life (HRQOL). This study examined whether depressive symptoms and HRQOL indicators changed among participants in Pasos Adelante, a chronic disease prevention and control program implemented in a US–Mexico border community. Methods Pasos Adelante was a 12-week promotora-led program that included educational sessions and walking groups. We used the Centers for Epidemiologic Studies Depression Scale (CES-D) and the Center for Disease Control’s “Healthy Days” measures to measure depressive symptoms and HRQOL. We used linear mixed-effects models and general estimating equations to analyze changes in CES-D scores and HRQOL indicators from baseline to postprogram and from postprogram to 3-month follow-up. Results At baseline, participants had a mean of 7.1 physically unhealthy days, 7.4 mentally unhealthy days, and 3.9 days of activity limitation. The mean number of physically and mentally unhealthy days declined significantly from baseline to postprogram, but the mean number of activity limitation days did not. At baseline, 42.6% of participants reported their health as fair/poor; 20.8% of participants reported frequent mental distress, and 31.8% had a CES-D score of 16 or more. All 3 proportions declined from baseline to postprogram. No significant changes occurred between postprogram and follow-up. Conclusion Participants in Pasos Adelante showed improvement in depressive symptoms and several HRQOL indicators. Future studies should use an experimental design with a comparison group to determine whether these findings can be replicated and to examine potential mediators and moderators of program effects.Item Effectiveness of the Pasos Adelante Chronic Disease Prevention and Control Program in a US-Mexico Border Community, 2005-2008(Centers for Disease Control and Prevention, 2012) Staten, Lisa K.; Cutshaw, Christina A.; Davidson, Christopher; Reinschmidt, Kerstin; Stewart, Rosie; Roe, Denise J.Introduction Pasos Adelante is a lifestyle intervention program facilitated by community health workers (promotores) targeting chronic disease prevention and control in Mexican Americans. Initial studies of Pasos Adelante indicated significant improvements in self-reported nutrition and physical activity. This study examined whether Pasos Adelante participants living in a US border community showed improvements in selected physiological measures after participating in the program and whether changes were maintained at 3-month follow-up. Methods The program took place in 12-week sessions from January 2005 to May 2008 and included walking groups and education targeting nutrition and physical activity. Questionnaires, anthropometric measures, and laboratory tests were conducted at baseline (n = 305), conclusion of program (n = 254), and 3-month follow-up (n = 221). Results Participants demonstrated decreases in body mass index (P = .04), waist and hip circumference (P < .001), diastolic and systolic blood pressure (P < .001), and total cholesterol (P = .008) from baseline to program conclusion. No values worsened significantly between program conclusion and follow-up, except systolic blood pressure. Glucose levels improved between conclusion and follow-up (P = .01). Conclusion These results support the initial findings of improvements in participants’ self-reported physical activity and nutrition patterns through changes in objective measures. This evidence-based program demonstrates the potential for a promotores-facilitated chronic disease prevention and control program to improve physical health and targets both primary and secondary prevention in Hispanic communities and organizations.Item Eficacia del programa de control y prevención deenfermedades crónicas "Pasos Adelante" en una comunidad enla frontera de EE. UU. y México, 2005-2008(Centers for Disease Control and Prevention, 2012) Staten, Lisa K.; Cutshaw, Christina A.; Davidson, Christopher; Reinschmidt, Kerstin; Stewart, Rosie; Roe, Denise J.Introducción "Pasos Adelante" es un programa de intervención sobre hábitos saludables facilitado por trabajadores de salud comunitaria o"promotores de salud" destinado a prevenir y controlar enfermedades crónicas en mexicoamericanos. Los estudios iniciales de"Pasos Adelante" mostraron mejoras significativas en la alimentación y la actividad física autorreportadas por los participantes.Este estudio evaluó si los habitantes de una comunidad en la frontera estadounidense que participaron en el programa mostraronmejorías en determinados valores fisiológicos y si los cambios se mantuvieron en el seguimiento a los 3 meses. Métodos El programa se llevó a cabo en sesiones de 12 semanas de enero del 2005 a mayo del 2008 e incluyó grupos de caminata y clases denutrición y actividad física. Se realizaron cuestionarios, mediciones antropométricas y pruebas de laboratorio al inicio delprograma (n = 305), al final (n = 254) y en el seguimiento a los 3 meses (n = 221). Resultados Al compararse los datos iniciales de referencia con los del final del programa, los participantes mostraron reducciones en su índicede masa corporal (P= .04), circunferencia de cintura y cadera (P< .001), presión arterial diastólica y sistólica (P< .001) y colesterol total (P= .008). Ningún valor empeoró significativamente entre la conclusión del programa y el seguimiento, aexcepción de la presión arterial sistólica. Los niveles de glucosa mejoraron entre la finalización y el seguimiento del programa (P=.01). Conclusión Estos resultados sustentan los hallazgos iniciales referidos a la mejoría autorreportada por los participantes en relación conpatrones de alimentación y actividad física al mostrar cambios en medidas objetivas. Este programa basado en la evidenciademuestra el potencial de los programas de control y prevención de enfermedades crónicas llevados a cabo por promotores desalud para mejorar la salud física abordando la prevención primaria y secundaria en organizaciones y comunidades hispanas.