Providing water and nutritional counseling was effective in increasing water intake and in partially decreasing SSB intake. We found no effect on plasma TGs, weight, and other cardiometabolic risks in the ITT analysis, although the intervention lowered plasma TGs and MetS prevalence among obese participants. Further studies are warranted. This trial was registered at http://www.clinicaltrials.gov as NCT01245010.
IntroductionBreastfeeding is recommended exclusively for the first 6 months after birth, with continued breastfeeding for at least 2 years. Yet prevalence of these recommendations is low globally, although it is an effective and cost-effective way to prevent serious infections and chronic illness. Previous studies have reported that social support greatly influences breastfeeding, but there is little evidence on perceived social norms in Mexico and how they affect actual behavior.ObjectiveOur objective was to investigate breastfeeding intention, practices, attitudes, and beliefs, particularly normative, among low-resource communities in central and southern Mexico.MethodsWe performed a secondary analysis using the theory of planned behavior with cross-sectional data, which included semi-structured individual interviews with fathers (n 10), 8 focus groups with mothers (n 50), and 8 focus groups with women community leaders (n 44) with a total of 104 participants. Our data also included a quantitative survey among pregnant women and mothers (n 321).ResultsWomen reported supplementing breast milk with water and teas soon after birth, as well as introducing small bites of solid food a few months after birth. Social norms appeared to support breastfeeding, but not exclusive breastfeeding or breastfeeding for periods longer than about a year. This may be partially explained by: a) behavioral beliefs that for the first 6 months breast milk alone is insufficient for the baby, and that water in addition to breast milk is necessary to hydrate an infant and b) normative beliefs related to the appropriateness of breastfeeding in public and as the child gets older.ConclusionsFuture strategies should focus on positively influencing social norms to support recommended practices, and emphasize the specific reasons behind the recommendations. Future efforts should take a multi-pronged approach using a variety of influences, not only directed at healthcare providers but close family members, including fathers.
Commitment and participation were determined by group dynamics and structural factors such as socioeconomic conditions and gender roles. These determinants must be visible and understood in order to generate proposals that are aimed at strengthening the participation and organization of groups.
Objective
To describe the design, methods, and challenges encountered during a randomized clinical trial aimed to promote water intake for reducing risks of metabolic syndrome in Mexican women.
Materials and methods
In a randomized clinical trial in Cuernavaca, Mexico, overweight and obese (body mass index [BMI] ≥ 25 < 39) women, 18 – < 45 years old with an intake of sugar-sweetened beverages ≥ 250 kilocalories per day (kcal/day) were randomly allocated to the water and education provision group (n = 120) or the education provision only group (n = 120).
Results
We screened 1 756 women. The main difficulties encountered were identifying participants with the recruitment criteria, delivering water to participants, and the time demanded from the study participants.
Conclusions
The trial’s main challenges were difficulties surrounding recruitment, delivery of the intervention, and the time demanded from the study participants. Modifications were effectively implemented without jeopardizing the original protocol.
Objetivo: analizar la capacidad de respuesta comunitaria (CR) hacia la obesidad, diabetes e hipertensión (ODH) para el desarrollo de iniciativas de promoción de la salud en una comunidad de origen náhuatl en México. Material y métodos: estudio basado en el Modelo de Capacidad de Respuesta Comunitaria (MCRC) con abordaje cualitativo. Entrevistamos ocho informantes clave. Realizamos la asignación de valores por dimensión utilizando la escala del MCRC y el análisis de contenido para comprender los factores involucrados en la CR. Resultados: la etapa de CR identificada fue de “concientización vaga” (valor 3). Se reconocieron los elementos que dificultan el involucramiento de la comunidad. Discusión: valorar la CR es imprescindible para generar estrategias apropiadas. El MCRC resultó útil para profundizar en la ODH como fenómeno social en un contexto como el de Xoxocotla. El análisis cualitativo fue indispensable para comprender la CR y las consideraciones necesarias para generar iniciativas efectivas.
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