A promotores de salud intervention to reduce cardiovascular disease risk in a high-risk Hispanic border population, 2005-2008.
BACKGROUND
The high prevalence of cardiovascular disease (CVD) in the Hispanic population of the United States, together with low rates of health insurance coverage, suggest a potential cardiovascular health crisis. The objective of Project HEART (Health Education Awareness Research Team) was to promote behavior changes to decrease CVD risk factors in a high-risk Hispanic border population.


METHODS
Project HEART took place from 2005 through 2008 as a randomized community trial with a community-based participatory research framework using promotores de salud (community health workers). A total of 328 participants with at least 1 CVD risk factor were selected by randomizing 10 US Census tracts in El Paso, Texas, to either the experimental or the control group. The experimental group (n = 192) was assigned to a series of 8 health classes using the Su Corazón, Su Vida curriculum. After 2 months of educational sessions, the group was followed for 2 months. The control group (n = 136) was given basic educational materials at baseline, and no other intervention was used. Main outcomes of interest included changes in health behaviors and clinical measures.


RESULTS
Participants in the experimental group showed more awareness of CVD risk factors, more confidence in the control of these factors, and improved dietary habits (ie, lower salt and cholesterol intake, better weight-control practices) compared with the control group. Total cholesterol was 3% lower in the experimental than in the control participants, and nonhigh-density lipoprotein cholesterol and low-density lipoprotein cholesterol were both 5% lower.


CONCLUSIONS
The HEART trial suggests that community health education using promotores de salud is a viable strategy for CVD risk reduction in a Hispanic border community.
University of Texas at Houston Health Science Center, School of Public Health, El Paso Regional Campus, 1100 N Stanton St, El Paso, TX 79902, USA. hector.g.balcazar@uth.tmc.edu
Héctor G
HG
Balcázar
Hendrik
H
de Heer
Lee
L
Rosenthal
Melissa
M
Aguirre
Leticia
L
Flores
Flor A
FA
Puentes
Victor M
VM
Cardenas
Maria O
MO
Duarte
Melchor
M
Ortiz
Leslie O
LO
Schulz
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003153:Community Health Services; D003150:Community Health Workers; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D013997:Time Factors