DESCRIPTION (provided by applicant): When immigrants arrive from Mexico, their overall risk for cancer is lower than among U.S.-born Latinos and non-Latinos living in the U.S. However, the longer immigrants live in the U.S., the closer this subgroup's prevalence of certain cancers approximates those found among U.S.-born Latinos and non-Latinos in the U.S. Rates of overweight and obesity follow a similar pattern with the prevalence of obesity higher among immigrants living in the U.S. for more years and among U.S.-born Latinos. One explanation for these phenomena is change in dietary behaviors. The goal of this study is to test the feasibility and short-term efficacy of a diet-based cancer prevention/energy balance intervention for immigrant Latinos. In the Southeastern U.S., tiendas (Latino grocery stores) are fast becoming an important place where Latinos go for information and resources. This study proposes to capitalize on this natural source of support by working with tiendas to promote healthy dietary behaviors. The "Marketing health to Latinos through tiendas" study consists of two phases. Phase 1 will involve formative research with three components: interviews with food suppliers to identify the best strategies for making healthy food products more available in tiendas; interviews with tienda managers to assess the feasibility of intervention activities; and focus groups with tienda customers to evaluate the perceived efficacy of intervention activities. Phase 2 will assess the feasibility and short-term efficacy of a group randomized controlled trial with two conditions: environmental change and food marketing intervention versus a delayed control condition. The environmental change component will involve creating a healthy product section in the store that promotes sales of fruits, vegetables, low-fat products, and alternatives to sugary beverages. The food marketing component will employ various food marketing strategies to promote sales of healthy .foods. We will match two tiendas in one county with two tiendas in a second county and then randomly assign one tienda in each county to the intervention or control condition. Assessment of the primary target for change, fruit and vegetable consumption among 160 tienda customers, will be measured at baseline, immediately post-intervention (week 8), and following delivery of the delayed control condition (week 16). Changes in tienda customer fat and sugary beverage consumption, as well as changes in the tienda environment will also be assessed. If successful, this project has the potential to lead to a larger R01 targeting dietary behavior change and obesity among Latinos, as well as other cancer prevention behaviors (i.e., increased physical activity, reduction in tobacco use) in a novel setting.
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