Salud y Nutrición Para Todos (Health and Nutrition for All) Program

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MSK’s Salud y Nutrición para todos (health and nutrition for all) program, SANOS for short, is set up to address the obesity crisis among Hispanic people, the largest and fastest growing immigrant and minority population in the US, most of whom are from Mexico.

The majority of US-based Mexican men and women (81.9% and 78.3% respectively) are overweight or obese, compared to non-Hispanic white men and women (73.2% and 60.9% respectively).

Obesity is a shared risk for both cardiovascular disease and cancer, and there is a dearth of optimized lifestyle interventions for minority populations designed to reduce participant burden and costs, as well as promote meaningful weight loss. SANOS uses an innovative methodological framework, the Multiphase Optimization Strategy (MOST), to design an optimized version of a scalable, culturally and linguistically tailored diet and lifestyle intervention for the Mexican population in the US. This program works in tandem with the Ventanillas de Salud (Health Windows) program at the Mexican Consulate.

Objectives

  1. To identify which of the four obesity intervention components contribute most to decreasing weight by at least 5% from baseline — a percentage loss associated with numerous health benefits (primary outcome) — among overweight or obese individuals at six months post-intake. The intervention components are 1) initial in-person, individual diet and exercise counseling; 2) thrice-weekly diet and exercise text messages; 3) weekly telephone support; and 4) self-monitoring tools. Secondary outcomes include improvements in BMI, waist circumference, HgbA1c, cholesterol, blood pressure, and diet and exercise behavior.

  2. To estimate the cost and incremental cost-effectiveness of the obesity intervention components, delivered individually and in combination.

  3. To conduct mediation analyses to assess whether changes in mediators, including self-efficacy, outcome expectancies, and nutrition knowledge, attitudes, and beliefs, are associated with certain intervention components and study outcomes.