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

Héctor Balcázar, Matilde Alvarado, Frank Cantu, Veronica Pedregon, Robert Fulwood, Héctor Balcázar, Matilde Alvarado, Frank Cantu, Veronica Pedregon, Robert Fulwood

Abstract

Introduction: 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).

Conclusion: 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.

References

    1. American Heart Association. Heart disease and stroke statistics, 2004 update. [Accessed August 4, 2008]. .
    1. Centers for Disease Control and Prevention. Heart disease death rates for 1996 through 2000 for Hispanics. [Accessed August 4, 2008]. .
    1. Balcázar H, Alvarado M, Luna Hollen M, Gonzalez-Cruz Y, Pedregon V. Evaluation of Salud para su Corazón (Health for Your Heart) — NCLR national dissemination promotora outreach projects. Prev Chronic Dis. 2005;2(3):A08. .
    1. Balcázar H, Alvarado M, Luna Hollen M, Gonzalez-Cruz Y, Hughes O, Vazquez E, et al. Salud para su Corazón-NCLR: a comprehensive promotora outreach program to promote heart healthy behaviors among Latinos. Health Promot Pract. 2006;71:68,77.
    1. Balcázar H, Luna Hollen M, Medina A, Pedregon V, Alvarado M, Fulwood R. The North Texas Salud para su Corazón Promotor/a outreach program: an enhanced dissemination initiative. The Health Education Monograph Series 2006;22(1):19–27.
    1. Medina A, Balcázar H, Luna Hollen M, Nkoma E, Soto Mas F. Promotores de Salud: educating Hispanic communities on heart-healthy living. Am J Health Educ 2007;38(4):194–202.
    1. National Heart, Lung, and Blood Institute. Salud para su Corazón national dissemination: evaluation of the implementation of Salud para su Corazón by lay health educators in 7 Latino communities, 2001. Bethesda (MD): National Institutes of Health; 2003.
    1. Alcalay R, Alvarado M, Balcázar H, Newman A, Huerta E. Salud para su Corazón: a community-based Latino cardiovascular disease prevention and outreach model. J Community Health. 1999;24(5):359–379.
    1. Krieger J, Collier C, Song L, Martin D. Linking community-based blood pressure measurement to clinical care: a randomized controlled trial of outreach and tracking by community health workers. Am J Public Health. 1999;89(6):856–861.
    1. Brownstein JN, Bone LR, Dennison CR, Hill MN, Kim MT, Levine DM. Community health workers as interventionists in the prevention and control of heart disease and stroke. Am J Prev Med. 2005;29(5S1):128–133.
    1. Rosenthal EL, Wiggins N, Brownstein JN, Johnson S, Borbon IA, Rael R, et al. Report of the national community health advisor study: weaving the future. Tucson, AZ: University of Arizona Press; .
    1. Perez L, Martinez J. Community health workers: social justice and policy advocates for community health and well-being. Am J Public Health. 2008;98:11–14.
    1. Anders R, Balcázar H, Paez L. Hispanic community-based participatory research using a promotores de salud model. Hispanic Health Care International 2006;4(2):71–78.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する