Despite the steady improvement in the health status of Americans, Hispanics are a minority in the United States with greater prevalence of several infectious and chronic diseases and less health knowledge than the average citizen. Nearly half of the Hispanics living in this country die of preventable nutrition-related conditions, with heart disease and cancer being the leading causes. Since this minority has limited access to health care and preventive services, there is a need for an inexpensive, viable model of health education for this underserved segment of the population in order to lower the excess of preventable diseases. We trained lay individuals as peer nutrition educators to improve the access to primary prevention among this medically marginlized minority. We tested the effectiveness of nutrition education delivered by peer nutrition educators to increase fruit and vegetable consumption and to lower the intake of total fat and saturated fat among low income, low literacy, Mexican-American women attending a Spanish-language WIC clinic.

This randomized clinical trial had pre/posttest evaluations of diet and self-efficacy at the beginning and end of the 17 week intervention. At baseline there were 98 experimental and 97 control women. We report the results from the 82 experimental and 72 control women who completed the study. The experimental group received peer nutrition education. The control group received conventional health education delivered by registered dietitians. Both groups received three 45-minutes classes during three consecutive months.

The experimental group significantly increased fruit consumption (1 serving) and decreased the percent of calories from total fat and saturated fat. Vegetable consumption remained unchanged in both groups. Dietary self-efficacy modestly increased in the experimental group and significantly dropped in the control.

The subjects receiving peer nutrition education reached the national recommendations for the prevention of chronic disease by reducing their consumption of calories from fat to 30% and saturated fat to 9%, and by exceeding the goal of 5 servings of fruits and vegetables per day. This trial demonstrates that peer nutrition education is an effective model to promote eating behaviors to prevent diet-related chronic disease among Mexican-American women.

LLU Discipline





School of Public Health

First Advisor

Patricia Johnston

Second Advisor

Ella Haddad

Third Advisor

Jerry Lee

Fourth Advisor

Albert Sanchez

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Peer Group; Nutrition -- education; Hispanic Americans -- education; Health Education; Women's Health; Community Health Workers; Health Promotion -- methods; Program Evaluation; Self-Help Groups.



Page Count

x; 207

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives