Long-Term Follow-Up of a Lifestyle Intervention for Late-Midlife, Rural-Dwelling Latinos in Primary Care
Stacey L. Schepens Niemiec, Cheryl Vigen, Jenny Martínez, Jeanine Blanchard, Mike Carlson
Abstract
IMPORTANCE: Rural-dwelling Latinos are an underresourced population in need of accessible and effective wellness programs. OBJECTIVE: To evaluate patients' long-term health-related outcomes after lifestyle intervention. DESIGN: An uncontrolled pilot trial assessing change in health from pretreatment to long-term follow-up (12 mo after intervention completion, no contact) and from posttreatment to long-term follow-up. SETTING: Rural, community-based primary care. PARTICIPANTS: Latino and Hispanic safety-net primary care patients, ages 50 to 64 yr. INTERVENTION: A culturally tailored, 4-mo lifestyle intervention co-led by occupational therapy practitioners and Latino community health workers that features telehealth and in-home sessions covering topics such as healthy eating and navigating health care. OUTCOMES AND MEASURES: Self-reported and physiological outcomes: symptom-well-being (primary), stress, sleep disturbance, social satisfaction, physical activity, patient activation, blood pressure, and weight. Exit interviews addressed health experiences and intervention impact on participants' lives. RESULTS: Participants (N = 27) demonstrated clinically significant pretreatment to long-term follow-up benefits in all symptom-well-being dimensions (Cohen's d ≥ 0.8, p ≤ .004), with additional gains from posttreatment to long-term follow-up (d ≥ 0.4, p ≤ .05). Significant improvements from pre- to posttreatment in systolic blood pressure, stress, and social role and activity satisfaction were maintained at long-term follow-up. No changes were observed in weight, physical activity, or diastolic blood pressure. Participants described the intervention's sustained positive effect on their wellness. CONCLUSIONS AND RELEVANCE: A lifestyle intervention led by occupational therapy practitioners and community health workers in a primary care context has potential to achieve long-term health benefits in rural-dwelling, late-midlife Latinos. WHAT THIS ARTICLE ADDS: This study reveals that rural, late-midlife Latinos showed long-lasting improvements in psychological and physical health after finishing a program that helped them make healthy lifestyle choices. This finding supports the unique contribution of occupational therapy in primary care settings.