title: Improved Cardiovascular Risk among Hispanic Border Participants of the Mi Corazón Mi Comunidad Promotores De Salud Model: The HEART II Cohort Intervention Study 2009-2013.
abstract: BACKGROUND
  Community resources (parks, recreational facilities) provide opportunities for health promotion, but little is known about how to promote utilization of these resources and their impact on cardiovascular disease risk (CVD).
  
  
  METHODS
  This cohort study evaluated the impact of an intervention called Mi Corazon Mi Comunidad (MiCMiC), which consisted of promoting use of community physical activity and nutrition resources by Promotoras de Salud/Community Health Workers. Participants were assessed at baseline and following the 4-month intervention. Attendance records were objectively collected to assess utilization of intervention programing.
  
  
  RESULTS
  A total of five consecutive cohorts were recruited between 2009 and 2013. Participants were mostly females (86.0%), on average 46.6 years old, and 81% were low in acculturation. Participants who completed follow-up (n = 413) showed significant improvements in reported health behaviors and body composition. Higher attendance significantly predicted greater improvements. The baseline to 4-month change for the highest vs. the lowest attendance quartiles were for weight (-5.2 vs. +0.01 lbs, p < 0.001), waist circumference (-1.20 vs. -0.56 inches, p = 0.047), hip circumference (-1.13 vs. -0.41 inches, p < 0.001); hours of exercise/week (+3.87 vs. +0.81 hours, p < 0.001), proportion of participants eating five servings of fruits and vegetables/day (+54.7 vs. 14.7%, p < 0.001).
  
  
  CONCLUSIONS
  Following the Promotora-led MiCMiC intervention, substantial improvements in health behaviors and modest improvements in cardiovascular risk factors were found. Greater utilization of community resources was associated with more favorable changes. This study provided preliminary evidence for the effectiveness of Promotora-led interventions for promoting use of existing community resources in CVD risk reduction.
authors.affiliation: Department of Physical Therapy and Athletic Training, Northern Arizona University , Flagstaff, AZ , USA.
authors.forename: Hendrik Dirk
authors.initials: HD
authors.lastname: de Heer
authors.affiliation: School of Public Health, University of Texas Health Science Center , Houston, TX , USA.
authors.forename: Hector G
authors.initials: HG
authors.lastname: Balcazar
authors.affiliation: School of Public Health, University of Texas Health Science Center , Houston, TX , USA.
authors.forename: Sherrie
authors.initials: S
authors.lastname: Wise
authors.affiliation: School of Public Health, University of Texas Health Science Center , Houston, TX , USA.
authors.forename: Alisha H
authors.initials: AH
authors.lastname: Redelfs
authors.affiliation: Project on Community Health Worker Policy and Practice, Institute for Health Policy, University of Texas School of Public Health , El Paso, TX , USA.
authors.forename: E Lee
authors.initials: EL
authors.lastname: Rosenthal
authors.affiliation: Department of Public Health Sciences, The University of Texas at El Paso , El Paso, TX , USA.
authors.forename: Maria O
authors.initials: MO
authors.lastname: Duarte
keywords: Hispanic; U.S.–Mexico border; cardiovascular disease; cohort; community health workers; community resources; parks and recreation