Comparison and Effectiveness of Behavioral Cardiovascular Interventions in High Risk Latinos
Cardiovascular disease (CVD) is the leading cause of death among Latinos. The use of promotoras, in conjunction with interpersonal and printed nutrition and exercise information can aid in healthy changes in Spanish speaking communities.8 Designing and delivering culturally appropriate interventions are critical for behavioral and nutritional success of Latinos.
This literature review will provide information of the evidence-based behavioral intervention strategies developed for and tested with Latinos in order to inform clinicians of options for supporting improved cardiovascular outcomes in high risk Latinos.
A literature search was performed in Pubmed that generated 110 RCT initial studies, four of which met the inclusion criteria after assessment for eligibility based on the following criteria: behavioral lifestyle intervention study, more than 1 CVD risk factor, biological outcomes reported (BP, Cholesterol, LDL, HDL, BMI and others), greater than 18 years old, and sample with 30% greater Hispanics.
All the studies used promotoras to deliver culturally appropriate interventions that combined nutritional and physical activity classes, walking routes and/or support groups. Hayashi et al showed statistically significant intervention effects, for reduce systolic blood pressure, 10-year CHD Risk score and an increase in physical activity (p<0.05). The reduction was by 6 points, making nutritional and physical counseling clinically relevant to potential reduction in blood pressure and improving CVD in Latinos. Furthermore, Balcazar et al demonstrated a reduction in the intervention’s cholesterol levels compared to the control group (p<0.05). Most studies demonstrated no significant changes in LDL, HDL or BMI.
This literature review provides initial evidence that culturally appropriate interventions such as using promotoras, bilingual materials/classes, appropriate cultural diet, exercise modifications and establishing a social support network provides potentially efficacious strategies for cardiovascular improvement in high risk Latinas.