title: Knowledge and behavioral effects in cardiovascular health: Community Health Worker Health Disparities Initiative, 2007-2010.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of death in the United States, and disparities in cardiovascular health exist among African Americans, American Indians, Hispanics, and Filipinos. The Community Health Worker Health Disparities Initiative of the National Heart, Lung, and Blood Institute (NHLBI) includes culturally tailored curricula taught by community health workers (CHWs) to improve knowledge and heart-healthy behaviors in these racial/ethnic groups.
  
  
  METHODS
  We used data from 1,004 community participants in a 10-session curriculum taught by CHWs at 15 sites to evaluate the NHLBI's health disparities initiative by using a 1-group pretest-posttest design. The curriculum addressed identification and management of cardiovascular disease risk factors. We used linear mixed effects and generalized linear mixed effects models to examine results.
  
  
  RESULTS
  Average participant age was 48; 75% were female, 50% were Hispanic, 35% were African American, 8% were Filipino, and 7% were American Indian. Twenty-three percent reported a history of diabetes, and 37% reported a family history of heart disease. Correct pretest to posttest knowledge scores increased from 48% to 74% for heart healthy knowledge. The percentage of participants at the action or maintenance stage of behavior change increased from 41% to 85%.
  
  
  CONCLUSIONS
  Using the CHW model to implement community education with culturally tailored curricula may improve heart health knowledge and behaviors among minorities. Further studies should examine the influence of such programs on clinical risk factors for cardiovascular disease.
authors: American Institutes for Research, Washington, DC.
authors: Margarita
authors: M
authors: Hurtado
authors: National Institutes of Health, National Heart, Lung, and Blood Institute, 31 Center Dr, MSC 2480, Room 4A29D, Bethesda, MD 20892. E-mail: Jovonni.spinner@nih.gov.
authors: Jovonni R
authors: JR
authors: Spinner
authors: American Institutes for Research, Washington, DC.
authors: Manshu
authors: M
authors: Yang
authors: American Institutes for Research, Washington, DC.
authors: Christian
authors: C
authors: Evensen
authors: American Institutes for Research, Washington, DC.
authors: Amy
authors: A
authors: Windham
authors: National Institutes of Health, Bethesda, Maryland.
authors: Gloria
authors: G
authors: Ortiz
authors: National Institutes of Health, Bethesda, Maryland.
authors: Rachel
authors: R
authors: Tracy
authors: National Institutes of Health, Bethesda, Maryland.
authors: Edward Donnell
authors: ED
authors: Ivy
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003150:Community Health Workers; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009043:Motor Activity; D012307:Risk Factors