RESUMEN
Salud Para Su Carozón is a culturally sensitive, community-based program to increase heart healthy knowledge and behaviors among Latinos. Promotoras were trained using a 10-session manual to teach participants from 7 communities about heart disease risk factors and skills to achieve heart healthy behaviors. In 435 participants with pre-to-post self-reported data, there were increases in physical activity outside of work (57%-78%), heart health knowledge (49%-76%), and confidence in preparing heart healthy meals (66%-81%) (all Ps < .001). Results suggest that promotoras can provide effective health education to improve heart health risk behaviors in select Latino communities.
Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Agentes Comunitarios de Salud/educación , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Hispánicos o Latinos/psicología , Educación del Paciente como Asunto , Desarrollo de Programa , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etnología , Servicios de Salud Comunitaria/organización & administración , Culinaria/métodos , Ejercicio Físico/psicología , Conocimientos, Actitudes y Práctica en Salud/etnología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , América Latina/etnología , Manuales como Asunto , Estados Unidos/epidemiologíaRESUMEN
INTRODUCTION: In 2002, the National Heart, Lung, and Blood Institute partnered with the Health Resources and Services Administration's (HRSA's) Bureau of Primary Health Care and Office of Rural Health Policy to address cardiovascular health in the US-Mexico border region. From 2003 through 2005, the 2 agencies agreed to conduct an intervention program using Salud para su Corazón with promotores de salud (community health workers) in high-risk Hispanic communities served by community health centers (CHCs) in the border region to reduce risk factors and improve health behaviors. METHODS: Promotores de salud from each CHC delivered lessons from the curriculum Your Heart, Your Life. Four centers implemented a 1-group pretest-posttest study design. Educational sessions were delivered for 2 to 3 months. To test Salud para su Corazón-HRSA health objectives, the CHCs conducted the program and assessed behavioral and clinical outcomes at baseline, 3 months, 6 months, and 12 months after the intervention. A 2-sample paired t test and analyses of variance were used to evaluate differences from baseline to postintervention. RESULTS: Changes in heart-healthy behaviors were observed, as they have been in previous Salud para su Corazón studies, lending credibility to the effectiveness of a promotores de salud program in a clinical setting. Positive changes were also observed in low-density lipoprotein cholesterol level, triglyceride level, waist circumference, diastolic blood pressure, weight, and glycated hemoglobin (HbA1c). CONCLUSION: Results suggest that integrating promotores de salud into clinical practices is a promising strategy for culturally competent and effective service delivery. Promotores de salud build coalitions and partnerships in the community. The Salud para su Corazón-HRSA initiative was successful in helping to develop an infrastructure to support a promotores de salud workforce in the US-Mexico border region.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Presión Sanguínea , LDL-Colesterol/sangre , Agentes Comunitarios de Salud , Relaciones Comunidad-Institución , Hemoglobina Glucada/metabolismo , Conductas Relacionadas con la Salud , Educación en Salud , Promoción de la Salud , Hispánicos o Latinos , Humanos , México/epidemiología , Desarrollo de Programa , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
Racial and ethnic minority communities need to be involved in developing health information to ensure its cultural appropriateness, improve its acceptability, and stimulate adoption of healthy behaviors. The National Heart, Lung, and Blood Institute at the National Institutes of Health adapted a heart-health curriculum for Latinos into culturally appropriate curricula for American Indians/Alaska Natives, African Americans, and Filipinos. Lessons learned from this process can assist public health practitioners interested in adapting science-based heart-health information into practical health education messages that meet the cultural and contextual needs of diverse groups.
Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Educación en Salud/métodos , National Heart, Lung, and Blood Institute (U.S.)/organización & administración , Negro o Afroamericano , Asiático , Cultura , Conductas Relacionadas con la Salud/etnología , Promoción de la Salud/métodos , Humanos , Indígenas Norteamericanos , Proyectos Piloto , Servicios Preventivos de Salud , Estados UnidosRESUMEN
This article describes results of year-1 implementation of the Salud Para Su Corazón (Health For Your Heart)-National Council of la Raza (NCLR) promotora (lay health worker) program for promoting heart-healthy behaviors among Latinos. Findings of this community outreach initiative include data from promotora pledges and self-skill behaviors, cardiovascular disease risk factors of Latino families, family heart-health education delivery, and program costs associated with promotora time. Participation included 29 trained promotoras serving 188 families from three NCLR affiliates in Escondido, California; Chicago, Illinois; and Ojo Caliente, New Mexico. Using several evaluation tools, the results showed that the promotora approach worked based on evidence obtained from the following indicators: changes in promotora's pre-post knowledge and performance skills, progress toward their pledge goals following training, recruiting and teaching families, providing follow-up, and organizing or participating in community events. Strengths and limitations of the promotora model approach are also discussed.
Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Agentes Comunitarios de Salud , Promoción de la Salud/métodos , Hispánicos o Latinos , Enfermedades Cardiovasculares/etnología , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Estados UnidosRESUMEN
INTRODUCTION: In 2001, the National Heart, Lung, and Blood Institute partnered with the National Council of La Raza to conduct a pilot test of its community-based outreach program Salud Para Su Corazón (Health for Your Heart), which aims to reduce the burden of morbidity and mortality associated with cardiovascular disease among Latinos. METHODS: The effectiveness of promotores de salud (community health workers) in improving heart-healthy behaviors among Latino families participating in the pilot program at seven sites was evaluated. Data on the characteristics of the promotores in the Salud Para Su Corazón program were compiled. Promotores collected data on family risk factors, health habits, referrals and screenings, information sharing, and program satisfaction from 223 participating Latino families (320 individual family members) through questionnaires. Paired t tests and chi-square tests were used to measure pretest-posttest differences among program participants. RESULTS: Results demonstrated the effectiveness of the promotora model in improving heart-healthy behaviors, promoting community referrals and screenings, enhancing information sharing beyond families, and satisfying participants' expectations of the program. The main outcome of interest was the change in heart-healthy behaviors among families. CONCLUSION: The community outreach model worked well in the seven pilot programs because of the successes of the promotores and the support of the community-based organizations. Successes stemmed in part from the train-the-trainer approach. Promotoria, as implemented in this program, has the potential to be integrated with a medical model of patient care for primary, secondary, and tertiary prevention.