The indirect effects of self-regulation on the association of social support with increased protective drinking behavior and decreased alcohol problems in a predominantly Hispanic college student sample.

BACKGROUND: Research suggests that self-regulation, which refers to one's ability to manage a behavior, and social support are related to alcohol use. Other research suggests that social support may serve as a precursor to self-regulation and health-promoting behaviors. We examined whether self-regulation has an indirect effect on the association between social support and both protective drinking behaviors and alcohol problems. METHODS: A random sample of students at a Hispanic Serving Institution completed an online survey, which included sociodemographic questions, the Multidimensional Perceived Social Support Scale, the Short Self-Regulation Questionnaire, the Protective Behavioral Strategies (PBS) Scale, and the Rutgers Alcohol Problem Index. Undergraduate students (n = 192) who reported drinking in the last month were included in the analysis. A path analysis using Mplus8 was conducted to investigate the relationships among social support, self-regulation, PBS, and alcohol-related problems. RESULTS: The sample was mostly female (58.9) and of Hispanic ethnicity (89.6). Analyses showed that social support had a significant positive association with PBS and a significant negative association with alcohol-related problems. When self-regulation was added to the models, these associations were no longer significant, and self-regulation had a significant indirect effect on the relationship between social support and both PBS and alcohol-related problems. CONCLUSIONS: The results of the current cross-sectional study suggest that a viable hypothesis in future longitudinal studies is that self-regulation is a mechanism by which social support increases PBS and reduces alcohol problems. Future research should assess longitudinally both the mediating effects of self-regulation between social support and drinking outcomes and potential moderators, such as ethnicity.

Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing.

PURPOSE: To determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention. DESIGN: Quasi-experimental evaluation. SETTING: El Paso, Texas. SAMPLE: Among 656 baseline participants, 374 (54%) completed the 12-month assessment. INTERVENTION: In Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6 months were identical across conditions. MEASURES: CHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale. ANALYSIS: Regression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment. RESULTS: Participants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23 kg (2.71 lbs.) and their BFP declined 2% over 12 months. CONCLUSION: Findings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.

Promoting Hispanic Immigrant Health via Community Health Workers and Motivational Interviewing.

Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.