July 1, 2003

Salud para su Corazón, or Health for Your Heart, has impacted the lives and health of almost 200 local Hispanic families since it began in 2001. The program, implemented locally by the School of Public Health at UNT Health Science Center, trains lay health educators, or promotores, to bring heart-healthy messages to their communities.

â??Many Hispanics are unaware of preventive measures to reduce the risk of heart disease, and cultural factors such as language barriers predispose Latinos not to have access to public health messages and health education,â? said principal investigator Hector Balcazar, PhD, chair and professor of social and behavioral sciences in the School of Public Health. â??This is especially problematic because cardiovascular disease is the leading cause of death in Latinos, and they have a disproportionate distribution of many of the risk factors for heart disease,â? he said.

Preliminary results from the first group of families completing the program indicate that the promotores have had a positive impact on the families they counseled and have been successfully communicating their message, said project co-director Mary Luna Hollen, PhD, RD, LD.

â??The families made healthier lifestyle choices and better understood the health effects of factors such as salt and sodium intake, cholesterol and fat, and weight control. The mothers also became more physically active, which may influence other family members to exercise more,â? she said.

The Salud para su Corazón team consists of 19 promotores, 29 network partner organizations and 10 public health students from the health science center. Participating families were divided into two groups and given a â??pre-testâ? to determine their behaviors and practices regarding various health-related subjects, she said.

The first group took part in six comprehensive family sessions on healthy lifestyle behaviors presented in Spanish by the promotores, who followed the families for six months, Dr. Hollen said.

Those families also received culturally sensitive health education on cardiovascular risk factors, physical activity, blood pressure and sodium, cholesterol and fat, healthy weight, and diet. Salud para su Corazón participants in this group have shown an increased understanding about how to lead healthier lifestyles, based on their responses to a â??post-testâ? given after they completed the program, Dr. Hollen said.

The second group of families is a comparison group designed to determine the effect of the promotora. â??We are determining if meeting with a promotora is more effective than traditional classroom settings or written material,â? she said. The families in the second group receive monthly educational materials by mail, a monthly telephone call and a post card every two to three months, but are not attending the promotora family sessions. Results from this group are expected to be analyzed later this year.

In August, a third group of 20-25 families will be studied for three months to gather more information about the effects of meeting with a promotora. The participants will include people already on medication for heart disease, diabetes or high blood pressure. They will participate in the six-lesson family session conducted by the promotores, who will target their sessions to address the familiesâ?? risk factors and health conditions, Dr. Hollen said.

The families in this clinical sample will be followed for a three-month period, and will also receive information by mail and phone calls from the promotora. Health science center researchers will assess the effect of the program by comparing the familiesâ?? answers on a test before starting the program to their answers after completing it.

â??The program has been very well received by the community. Families become very connected with the promotora and many family participants want to become a promotora themselves,â? said Dr. Hollen.

â??The Salud para su Corazón program was tailor-made to meet the needs of Latino families,â? Dr. Balcazar said. â??The promotores believe that our communities are like flowers, and we are to care for them and water them with â??dropletsâ?? of health information. Itâ??s a team effort where all voices are heard and all ideas are used.â?

â??The promotores are so dedicated to the program they will keep meeting with each other and with families on a volunteer basis after the formal program ends in January,â? Dr. Hollen said. â??A network of promotores and partner organizations is forming to pursue future support and funding of the program. Many of the network partners will also continue to provide supplies, meeting facilities and other support.â? Partners include hospitals, churches, community nonprofit organizations and many others.

The School of Public Health team is developing a model, complete with a multi-media CD-ROM, to show others how they implemented Salud para su Corazón and why the program is important. Planning, promotora training and evaluation will be among the topics discussed. They presented their recommendations in June at the national conference of the Society of Public Health Educators in New Mexico.

Salud para su Corazón was created by the National Institutes of Healthâ??s National Heart, Lung and Blood Institute in 1994 as a pilot project in Washington, DC. It now serves communities in Texas, Illinois, New Mexico and California. The School of Public Health was one of six organizations across the country selected to form the foundation of a national effort to educate people in low-income and minority communities about cardiovascular disease. The health science center received $429,000 over three years from the NHLBI to implement the program.


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