Design and Implementation of a Culturally-Tailored Randomized Pilot Trial: Puerto Rican Optimized Mediterranean-Like...

Area of Science:

• Cardiovascular Health
• Nutritional Science
• Public Health

Background:

• Mediterranean Diet (MedDiet) adherence is linked to improved cardiometabolic health.
• Limited research exists on MedDiet benefits for non-Mediterranean racial/ethnic minorities, who face higher chronic disease risks.
• These populations may find the MedDiet unfamiliar or inaccessible.

Purpose of the Study:

• To describe the design of a pilot trial evaluating a culturally tailored MedDiet-like intervention in Puerto Rico (PR).
• To assess the feasibility and potential efficacy of the Puerto Rican Optimized Mediterranean-like Diet (PROMED) intervention.

Main Methods:

• A 4-month, two-arm randomized pilot trial involving 50 adults in PR with cardiometabolic risk factors.
• Intervention group received culturally tailored MedDiet counseling, reinforced by text messages, and received specific food items.
• Control group received standard portion-control counseling and cooking utensils, with similar text message reinforcement.

Main Results:

• The PROMED intervention was designed for cultural appropriateness, acceptability, accessibility, and feasibility in PR.
• Study strengths include deep cultural integration, addressing structural barriers, and real-world setting application.
• Limitations involved challenges in blinding, adherence monitoring, and a reduced sample size; the COVID-19 pandemic impacted implementation.

Conclusions:

• The PROMED pilot trial provides a framework for culturally adapting the MedDiet for diverse populations.
• Further research is needed to confirm the efficacy of this tailored approach in improving cardiometabolic health.
• Successful implementation could support wider use of culturally appropriate MedDiet interventions for disease prevention.