College of Population Health MSC09 5070, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
School of Medicine, Family & Community Medicine, University of New Mexico, Albuquerque, NM, USA.
J Community Health. 2018 Aug;43(4):717-724. doi: 10.1007/s10900-018-0475-3.
Spanish speakers in the United States are in need of effective interventions that address both cardiovascular disease (CVD) and health literacy. However, the literature lacks interventions that have used and evaluated a strategies that focus on both, particularly at the community level. The aim of this study was to explore the effect of a health literacy curriculum on cardiovascular health behavior among Spanish speaking adults. It used a randomized controlled pre-posttest design. Participants included Hispanic adults with a low-to-intermediate level of English proficiency. The intervention group received the health literacy and English as a second language (ESL) Curriculum with CVD specific content, while the control group received a conventional ESL curriculum. Tools included the Spanish Cardiovascular Health Questionnaire (CSC), the test of functional health literacy in adults (TOFHLA), and the Combined English Language Skills Assessment. Analysis of change scores included independent sample t test and multiple linear regression. A total of 155 participants completed the study. There was a significant greater improvement for the intervention group in change of CSC score from pretest to posttest (P = 0.049) compared to controls. The study also found significantly improved TOFHLA (P = 0.011), however it did not find a relationship between changes in CVD behavior and health literacy or English proficiency. The Health Literacy and ESL Curriculum constitutes a valuable resource for addressing the cardiovascular health, literacy, and language needs of Spanish-speaking adults. Interventions that take a multilevel education and health approach may be more effective in addressing the needs of immigrants. Research should further explore the interactions between CVD behavior, health literacy, and English proficiency.
美国的西班牙语使用者需要有效的干预措施，以解决心血管疾病 (CVD) 和健康素养问题。然而，文献中缺乏既关注 CVD 又关注健康素养的干预措施，特别是在社区层面。本研究旨在探讨健康素养课程对西班牙语成年人心血管健康行为的影响。它采用了随机对照前后测试设计。参与者包括英语水平较低的西班牙裔成年人。干预组接受了健康素养和以英语为第二语言 (ESL) 的课程，内容涵盖 CVD 特定内容，而对照组接受了传统的 ESL 课程。工具包括西班牙语心血管健康问卷 (CSC)、成人功能性健康素养测试 (TOFHLA) 和综合英语语言技能评估。变化分数的分析包括独立样本 t 检验和多元线性回归。共有 155 名参与者完成了研究。与对照组相比，干预组在 CSC 评分从测试前到测试后的变化方面有显著更大的改善（P=0.049）。该研究还发现 TOFHLA 有显著改善（P=0.011），但没有发现 CVD 行为变化与健康素养或英语水平之间的关系。健康素养和 ESL 课程为满足西班牙语成年人的心血管健康、素养和语言需求提供了有价值的资源。采取多层次教育和健康方法的干预措施可能更能满足移民的需求。研究应进一步探讨 CVD 行为、健康素养和英语水平之间的相互作用。
