Siglang Buhay: Nutrition and physical activity promotion in filipino-americans through community organizations

Context: Intervening in organizations allows for targeting multiple levels of influence and greater potential for sustainability. Objective: To evaluate an 18-month nutrition and physical activity (NPA) intervention (Siglang Buhay) conducted through culturally specific organizations. Design: Site randomized trial with an active control group. Setting: Eighteen Filipino-American social clubs in San Diego County, California. Participants: Members of Filipino-American social clubs randomly assigned to NPA (n = 337) or cancer education (CE; n = 336) conditions. Intervention: Two to 3 members from each organization were trained to implement the interventions. The NPA focused on promoting fruit and vegetable consumption and physical activity and on decreasing dietary fat intake using health education, behavior change skills development, and organizational policy change. Cancer education focused on cancer education and cancer screening. Main Outcome Measures: Outcomes measured at baseline and at 18 months included 7-day self-reported physical activity and consumption of fruits and vegetables and low-fat foods, as well as stage of change for these 3 behaviors. Results: Longitudinal mixed-effects regression models indicated that the NPA participants showed significant increases in physical activity (B = 4.04; P < .05), adoption of a low-fat diet (OR = 3.72; P < .05), and stage of change for fruit and vegetables (B = 0.61; P < .05), dietary fat intake (B = 0.67; P < .01), and physical activity (B = 0.80; P < .01). The intervention did not lead to increases in the number of participants eating 5 servings of fruits and vegetables per day or more (OR = 2.26; P = not significant). Conclusions: Using culturally specific organizations to deliver NPA interventions was feasible and effective among Filipino-Americans. Similar multilevel approaches should be investigated in other cultures.