Peers important for nutrition education among Latinos

A systematic literature review conducted by a team of researchers from the University of Connecticut, the Hispanic Health Council (Hartford), and the Connecticut Centre for Eliminating Health Disparities among Latinos assessed the impact of peer education/counselling on nutrition and health outcomes among Latinos living in the United States. The results, published in the July/August issue of the Journal of Nutrition Education and Behaviour, provide evidence that peer nutrition education has a positive influence on diabetes self-management and breastfeeding outcomes, as well as on general nutrition knowledge and dietary intake behaviours, among Latinos in the US.

'Overall, these nutrition education demonstration studies suggest that peer education has the potential to change dietary behaviours among Latinos,' commented lead investigator Rafael Perez-Escamilla, PhD. 'There is a need to better understand how nutrition peer educators can be formally incorporated into the health care system within the Chronic Care Model community health worker (CHW) framework.' Latinos are the largest minority group in the United States, accounting for more than 12% of the population, and they are expected to be nearly 25% of the population by 2050. Latinos also have less access to nutritionally adequate and safe food - compared to 7.8% of non-Latino white individuals, almost 20% of Latinos are food insecure.

The group's findings are consistent with studies conducted with non-Latino white and black individuals, which suggests that it is important to formally incorporate peer nutrition educators as part of the CHW framework and to integrate them as part of US public health and clinical health care management. This strategy could contribute to addressing the health disparities that seriously affect Latinos, as well as other minority groups.

Additionally, this review produced the surprising finding that researchers could not identify any experimental or quasi-experimental study assessing the impact of the Food Stamp Nutrition Education Program (FSNE) on Latinos, even though this major program has been in place for over a decade. As many states include peer nutrition educators as part for their FSNE delivery strategies, this represents a major gap in knowledge.

Researchers also found a need for longitudinal randomised trials testing the impact of peer nutrition education interventions for Latinos grounded on goal setting and culturally appropriate behavioural change theories. Operational research is needed to identify the optimal peer educator characteristics, the type of training that they should receive, the client loads and dosage (ie, frequency and amount of contact needed between peer educator and client) and the best educational approaches and delivery settings.