Abstract
Background
Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes.
Methods
Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms.
Results
Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains.
Conclusion
A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.
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References
Center for Disease Control and Prevention. Leading Causes of Death in Females United States, 2010. 2010. http://www.cdc.gov/women/lcod/2010/index.htm. Accessed 28 Sept 2014.
Bureau USC. 2012 National Population Projections. http://www.census.gov/population/projections/data/national/2012.html. Accessed 29 Dec 2014.
Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: a systematic review. Ethn Dis. 2007;17(1):143–52.
Daviglus ML, Talavera GA, Aviles-Santa ML, Allison M, Cai J, Criqui MH, et al. Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA. 2012;308(17):1775–84. doi:10.1001/jama.2012.14517.
Kaplan RC, Aviles-Santa ML, Parrinello CM, Hanna DB, Jung M, Castaneda SF, et al. Body mass index, sex, and cardiovascular disease risk factors among Hispanic/Latino adults: Hispanic community health study/study of Latinos. J Am Heart Assoc. 2014;3(4). doi:10.1161/jaha.114.000923.
Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, et al. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation. 2014;130(7):593–625.
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6):816–20.
Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88(4 Pt 1):1973–98.
Sentell T, Braun KL. Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California. J Health Commun. 2012;17 Suppl 3:82–99. doi:10.1080/10810730.2012.712621.
Langellier BA, Garza JR, Glik D, Prelip ML, Brookmeyer R, Roberts CK, et al. Immigration disparities in cardiovascular disease risk factor awareness. J Immigr Minor Health/Center Minor Public Health. 2012;14(6):918–25. doi:10.1007/s10903-011-9566-2.
Cheng EM, Chen A, Cunningham W. Primary language and receipt of recommended health care among Hispanics in the United States. J Gen Intern Med. 2007;22 Suppl 2:283–8. doi:10.1007/s11606-007-0346-6.
Pearson WS, Ahluwalia IB, Ford ES, Mokdad AH. Language preference as a predictor of access to and use of healthcare services among Hispanics in the United States. Ethn Dis. 2008;18(1):93–7.
Mosca L, Mochari H, Christian A, Berra K, Taubert K, Mills T, et al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113(4):525–34. doi:10.1161/circulationaha.105.588103.
Galbraith EM, Mehta PK, Veledar E, Vaccarino V, Wenger NK. Women and heart disease: knowledge, worry, and motivation. J Women’s Health (2002). 2011;20(10):1529–34. doi:10.1089/jwh.2010.2356.
Altman R, Nunez de Ybarra J, Villablanca AC. Community-based cardiovascular disease prevention to reduce cardiometabolic risk in Latina women: a pilot program. J Women’s Health (2002). 2014;23(4):350–7. doi:10.1089/jwh.2013.4570.
Crouch R, Wilson A, Newbury J. A systematic review of the effectiveness of primary health education or intervention programs in improving rural women’s knowledge of heart disease risk factors and changing lifestyle behaviours. Int J Evid-Based Healthc. 2011;9(3):236–45. doi:10.1111/j.1744-1609.2011.00226.x.
Villablanca AC, Arline S, Lewis J, Raju S, Sanders S, Carrow S. Outcomes of national community organization cardiovascular prevention programs for high-risk women. J Cardiovasc Transl Res. 2009;2(3):306–20. doi:10.1007/s12265-009-9118-5.
Rodriguez F, Christopher L, Johnson CE, Wang Y, Foody JM. Love your heart: a pilot community-based intervention to improve the cardiovascular health of African American women. Ethn Dis. 2012;22(4):416–21.
Leventhal H, Nerenz D, Steele DJ. Handbook of psychology and health: social psychosocial aspects of health. Hillsdale: Earlbaum; 1984. p. 219–52.
Hirani SP, Newman SP. Patients’ beliefs about their cardiovascular disease. Heart. 2005;91(9):1235–9. doi:10.1136/hrt.2003.025262.
Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007;115(11):1481–501. doi:10.1161/circulationaha.107.181546.
Bergman HE, Reeve BB, Moser RP, Scholl S, Klein WM. Development of a Comprehensive Heart Disease Knowledge Questionnaire. Am J Health Educ. 2011;42(2):74–87.
Mosca L, Hammond G, Mochari-Greenberger H, Towfighi A, Albert MA. Fifteen-year trends in awareness of heart disease in women: results of a 2012 American Heart Association national survey. Circulation. 2013;127(11):1254–63, e1–29. doi:10.1161/CIR.0b013e318287cf2f.
Giardina EG, Sciacca RR, Foody JM, D’Onofrio G, Villablanca AC, Leatherwood S, et al. The DHHS Office on Women’s Health Initiative to Improve Women’s Heart Health: focus on knowledge and awareness among women with cardiometabolic risk factors. J Women’s Health (2002). 2011;20(6):893–900. doi:10.1089/jwh.2010.2448.
Mochari-Greenberger H, Mills T, Simpson SL, Mosca L. Knowledge, preventive action, and barriers to cardiovascular disease prevention by race and ethnicity in women: an American Heart Association national survey. J Women’s Health (2002). 2010;19(7):1243–9. doi:10.1089/jwh.2009.1749.
Sacks FM, Katan M. Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease. Am J Med. 2002;113(Suppl 9B):13s–24.
Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90. doi:10.1056/NEJMoa1200303.
Sivalingam SK, Ashraf J, Vallurupalli N, Friderici J, Cook J, Rothberg MB. Ethnic differences in the self-recognition of obesity and obesity-related comorbidities: a cross-sectional analysis. J Gen Intern Med. 2011;26(6):616–20. doi:10.1007/s11606-010-1623-3.
Giardina EG, Sciacca RR, Flink LE, Bier ML, Paul TK, Moise N. Cardiovascular disease knowledge and weight perception among Hispanic and non-Hispanic white women. J Women’s Health (2002). 2013;22(12):1009–15. doi:10.1089/jwh.2013.4440.
Giardina EG, Mull L, Sciacca RR, Akabas S, Flink LE, Moise N, et al. Relationship between cardiovascular disease knowledge and race/ethnicity, education, and weight status. Clin Cardiol. 2012;35(1):43–8. doi:10.1002/clc.20992.
Gallo LC, Roesch SC, Fortmann AL, Carnethon MR, Penedo FJ, Perreira K, et al. Associations of chronic stress burden, perceived stress, and traumatic stress with cardiovascular disease prevalence and risk factors in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Psychosom Med. 2014;76(6):468–75.
DuBard CA, Garrett J, Gizlice Z. Effect of language on heart attack and stroke awareness among U.S. Hispanics. Am J Prev Med. 2006;30(3):189–96. doi:10.1016/j.amepre.2005.10.024.
Liu KY, Haukoos JS, Sasson C. Availability and quality of cardiopulmonary resuscitation information for Spanish-speaking population on the Internet. Resuscitation. 2014;85(1):131–7. doi:10.1016/j.resuscitation.2013.08.274.
Flink LE, Sciacca RR, Bier ML, Rodriguez J, Giardina EG. Women at risk for cardiovascular disease lack knowledge of heart attack symptoms. Clin Cardiol. 2013;36(3):133–8. doi:10.1002/clc.22092.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–292. doi:10.1161/01.cir.0000441139.02102.80.
Lindberg NM, Stevens VJ, Halperin RO. Weight-loss interventions for Hispanic populations: the role of culture. J Obes. 2013;2013:542736. doi:10.1155/2013/542736.
Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L, Lin PH, et al. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med. 2010;170(2):126–35. doi:10.1001/archinternmed.2009.470.
Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, et al. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003;289(16):2083–93. doi:10.1001/jama.289.16.2083.
Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4), e1000058. doi:10.1371/journal.pmed.1000058.
Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000(5). Informed consent was obtained from participants for being included in the study.
Conflict of Interest
Daniela Romero, MD, Aileen Sauris, NP, Fátima Rodriguez, MD, MPH, Daniela Delgado BS, Ankita Reddy, and JoAnne M. Foody MD declare that they have no conflicts of interest.
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Romero, D.C., Sauris, A., Rodriguez, F. et al. Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women. J. Racial and Ethnic Health Disparities 3, 99–107 (2016). https://doi.org/10.1007/s40615-015-0119-6
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DOI: https://doi.org/10.1007/s40615-015-0119-6