Koniak-Griffin Deborah, Brecht Mary-Lynn, Takayanagi Sumiko, Villegas Juan, Melendrez Marylee, Balcázar Héctor
Audrienne H. Moseley Endowed Chair, Women's Health Research, School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States.
School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States.
Int J Nurs Stud. 2015 Jan;52(1):75-87. doi: 10.1016/j.ijnurstu.2014.09.005. Epub 2014 Sep 22.
Low-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is "promotora(s)."
This study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas.
A community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35-64 years, predominantly with low income and ≤8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012.
Women in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and participation in the individual teaching and counseling sessions and high retention rates support the feasibility and acceptability of the promotora-led lifestyle behavior intervention.
Our findings demonstrate that lifestyle behaviors and other risk factors of overweight Latina women may be improved through a promotora-led lifestyle behavior intervention. Feasibility of implementing this intervention in community settings and engaging promotoras as facilitators is supported.
低收入拉丁裔女性（西班牙裔）由于超重/肥胖率高、久坐不动的生活方式及其他因素，面临心血管疾病风险。获得医疗保健的机会有限以及语言障碍可能会阻碍健康促进信息的传递。可能需要采取有针对性的方法，包括整合社区卫生工作者，以促进服务不足的少数族裔群体养成健康的生活方式并预防慢性病。在拉丁裔社区中，通常用来指代女性社区卫生工作者的术语是“健康促进者”。
本研究评估由健康促进者主导的针对超重的移民拉丁裔女性的生活方式行为干预的效果和可行性。
采用社区预防模型来规划和实施本研究。使用随机对照试验设计。一个社区咨询委员会提供了评估在社区中实施研究的可行性及其他重要指导方面的专业知识。样本包括223名年龄在35 - 64岁之间的女性，她们主要低收入且受教育程度≤八年级。经过文化调适的生活方式行为干预包括小组教育（基于“Su Corazon, Su Vida”开展8次课程），随后是4个月的个人教学和辅导（家访和电话沟通）。对照组接受了时长相当的教育项目及随访联系。在基线以及第6个月和第9个月时，使用饮食习惯问卷、身体活动的加速度计读数以及临床指标（体重指数、体重、腰围、血压、血脂、血糖）进行评估。数据收集时间为2010年1月至2012年8月。
与对照组相比，干预组女性在饮食习惯、腰围和身体活动方面有显著改善。在体重和腰围方面观察到了治疗剂量效应。关于心脏病的知识有所增加。课程高出勤率、对个人教学和咨询环节的高参与度以及高留存率支持了由健康促进者主导的生活方式行为干预的可行性和可接受性。
我们的研究结果表明，通过由健康促进者主导的生活方式行为干预，超重拉丁裔女性的生活方式行为及其他风险因素可能会得到改善。本研究支持了在社区环境中实施这种干预以及让健康促进者作为促进者参与其中的可行性。
