Matilde Alvarado

Salud Para Su Corazón-NCLR: A Comprehensive Promotora Outreach Program to Promote Heart-Healthy Behaviors Among Hispanics

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.

Salud para su Corazón: a community-based Latino cardiovascular disease prevention and outreach model.

Cardiovascular disease (CVD) is the leading cause of death for Latinos living in the United States. This population is generally unaware of important lifestyle or behavioral changes that can prevent CVD. The National Heart, Lung, and Blood Institute (NHLBI) designed and implemented Salud para su Corazón (Health for Your Heart), a culturally appropriate, community-based, theory-driven intervention model. NHLBIs goals were: (1) to design an intervention model appropriate to Latino populations; (2) to pilot test the model in a specific community with the objectives of increasing awareness about heart disease, raising knowledge about CVD prevention, and promoting heart-healthy lifestyles; and (3) to disseminate the model and the materials developed to other communities with similar needs. An agency-community partnership, under the leadership of the Community Alliance for Heart Health, guided all stages of the community intervention project. The multimedia bilingual community intervention included television telenovela format public service announcements (PSAs), radio programs, brochures, recipe booklets, charlas, a promotores training manual, and motivational videos. An evaluation survey assessed the impact of the intervention. A pre-post intervention survey was conducted with more than 300 participants, and results showed that the respondents were substantially more aware of risk factors for CVD, and had greatly increased their knowledge of ways to prevent heart disease. Dissemination efforts have resulted in numerous requests by health organizations, universities, and health maintenance organizations (HMOs) for educational materials and communication strategies produced by Salud para su Corazón. In addition, Univision, the largest Spanish-language broadcast television network, is airing the initiatives PSAs. Also, training seminars for promotores are being conducted in differ ent regions of the United States, and several locations are planning to replicate this study.

Heart disease education and prevention program targeting immigrant Latinos: Using focus group responses to develop effective interventions

Although research has provided considerable knowledge concerning the positive effects of behavioral change on morbidity and mortality from heart disease and related risk factors, some segments of the population have not benefited equitably from this information. In April 1995, the National Heart, Lung, and Blood Institute (NHLBI) conducted seven focus groups to determine knowledge and attitudes about heart disease and associated risk factors, identify media usage and preferences, and assess publications usage and preferences among Spanish-speaking Latino immigrants residing in the Washington, D.C., metropolitan area. This information was gathered to assist in the development of key messages and strategies for the NHLBI Latino Community Cardiovascular Disease Prevention and Outreach Initiative, Salud para su Corazón—a heart disease prevention and education campaign. Findings from these focus groups indicate that Latinos may not benefit from heart disease prevention messages developed for the general population because of language and cultural differences. The researchers concluded that health education and disease prevention programs targeting the Latino community should develop educational materials and interventions that address language preferences and cultural values. Furthermore, to be effective, these programs should show people how to make positive behavioral changes based on their current circumstances, while remaining sensitive to the fact that Latino immigrants face major life adjustments and many are still greatly influenced by their country of origin.

Salud para su corazon (Health for your heart) community health worker model: Community and clinical approaches for addressing cardiovascular disease risk reduction in hispanics/latinos

This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

Evaluation of a Community-Based Latino Heart Disease Prevention Program in Metropolitan Washington D.C.

Cardiovascular disease (CVD) is the leading cause of death for Latinos living in the United States. This population is generally unaware of important lifestyle or behavioral changes that can prevent CVD. The National Heart, Lung, and Blood Institute (NHLBI) in collaboration with a community alliance designed and implemented Salud para su Corazón (Health for Your Heart), a culturally specific, community-based initiative to increase awareness about heart disease risk factors and knowledge about heart disease prevention, and to promote heart-healthy lifestyles. The initiative included messages about smoking cessation; weight loss if overweight; increase in physical activity; and checking blood pressure and cholesterol and treating them if high. Messages were communicated through multiple mass media, interpersonal, and outreach channels. A summative evaluation assessed the impact of the campaign. A pre- and post-campaign survey was conducted in the intervention community to assess whether the messages reached the target audience, and if the initiative had an effect. The sample of respondents included over 300 participants. Results showed that respondents were significantly more aware of risk factors for CVD after the campaign, and had greatly increased their knowledge of ways to prevent heart disease. Current behaviors to prevent cardiovascular disease had not changed at the post campaign measurement. Television, radio, and doctors were the most frequently cited sources of information for learning about the Salud para su Corazón initiative. Furthermore, the specific messages recalled and the source of information cited at post-test were similar to those promoted in the campaign, indicating it was successful in reaching the target audience.