Preventing Chronic Disease | Knowledge and Behavioral Effects in Cardiovascular Health: Community Health Worker Health Disparities Initiative, 2007–2010 - CDC
Knowledge and Behavioral Effects in Cardiovascular Health: Community Health Worker Health Disparities Initiative, 2007–2010
Margarita Hurtado, PhD, MHS; Jovonni R. Spinner, MPH; Manshu Yang, PhD; Christian Evensen, MS; Amy Windham, PhD, MPH; Gloria Ortiz, MS; Rachael Tracy, MPH; Edward Donnell Ivy, MD, MPH
Suggested citation for this article: Hurtado M, Spinner JR, Yang M, Evensen C, Windham A, Ortiz G, et al. Knowledge and Behavioral Effects in Cardiovascular Health: Community Health Worker Health Disparities Initiative, 2007–2010. Prev Chronic Dis 2014;11:130250. DOI: http://dx.doi.org/10.5888/pcd11.130250
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Abstract
Introduction
Cardiovascular disease is the leading cause of death in the United States, and disparities in cardiovascular health exist among African Americans, American Indians, Hispanics, and Filipinos. The Community Health Worker Health Disparities Initiative of the National Heart, Lung, and Blood Institute (NHLBI) includes culturally tailored curricula taught by community health workers (CHWs) to improve knowledge and heart-healthy behaviors in these racial/ethnic groups.
Cardiovascular disease is the leading cause of death in the United States, and disparities in cardiovascular health exist among African Americans, American Indians, Hispanics, and Filipinos. The Community Health Worker Health Disparities Initiative of the National Heart, Lung, and Blood Institute (NHLBI) includes culturally tailored curricula taught by community health workers (CHWs) to improve knowledge and heart-healthy behaviors in these racial/ethnic groups.
Methods
We used data from 1,004 community participants in a 10-session curriculum taught by CHWs at 15 sites to evaluate the NHLBI’s health disparities initiative by using a 1-group pretest–posttest design. The curriculum addressed identification and management of cardiovascular disease risk factors. We used linear mixed effects and generalized linear mixed effects models to examine results.
We used data from 1,004 community participants in a 10-session curriculum taught by CHWs at 15 sites to evaluate the NHLBI’s health disparities initiative by using a 1-group pretest–posttest design. The curriculum addressed identification and management of cardiovascular disease risk factors. We used linear mixed effects and generalized linear mixed effects models to examine results.
Results
Average participant age was 48; 75% were female, 50% were Hispanic, 35% were African American, 8% were Filipino, and 7% were American Indian. Twenty-three percent reported a history of diabetes, and 37% reported a family history of heart disease. Correct pretest to posttest knowledge scores increased from 48% to 74% for heart healthy knowledge. The percentage of participants at the action or maintenance stage of behavior change increased from 41% to 85%.
Average participant age was 48; 75% were female, 50% were Hispanic, 35% were African American, 8% were Filipino, and 7% were American Indian. Twenty-three percent reported a history of diabetes, and 37% reported a family history of heart disease. Correct pretest to posttest knowledge scores increased from 48% to 74% for heart healthy knowledge. The percentage of participants at the action or maintenance stage of behavior change increased from 41% to 85%.
Conclusion
Using the CHW model to implement community education with culturally tailored curricula may improve heart health knowledge and behaviors among minorities. Further studies should examine the influence of such programs on clinical risk factors for cardiovascular disease.
Using the CHW model to implement community education with culturally tailored curricula may improve heart health knowledge and behaviors among minorities. Further studies should examine the influence of such programs on clinical risk factors for cardiovascular disease.
Author Information
Corresponding Author: Jovonni R. Spinner, MPH, National Institutes of Health, National Heart, Lung, and Blood Institute, 31 Center Dr, MSC 2480, Room 4A29D, Bethesda, MD 20892. Telephone: 301-496-1051. E-mail: Jovonni.spinner@nih.gov.
Author Affiliations: Margarita Hurtado, Manshu Yang, Christian Evensen, Amy Windham, American Institutes for Research, Washington, DC; Gloria Ortiz, Rachael Tracy, Edward Donnell Ivy, National Institutes of Health, Bethesda, Maryland.
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