A promotora de salud model for addressing cardiovascular disease risk factors in the US-Mexico border region.
BACKGROUND
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).


CONCLUSIONS
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.
Balcázar
Héctor
H
University of Texas Health Science Center at Houston, School of Public Health, El Paso Regional Campus, 1100 N Stanton St, Ste 100, El Paso, TX 79902, USA. Hector.G.Balcazar@uth.tmc.edu
Alvarado
Matilde
M
Cantu
Frank
F
Pedregon
Veronica
V
Fulwood
Robert
R
D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003150:Community Health Workers; D003159:Community-Institutional Relations; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion; D006630:Hispanic or Latino; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D016730:Program Development; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human