Boden-Albala Bernadette, Draughter-Espinoza Darnisha, Castro Megan, Gutierrez Desiree, Cardenas Cassandra, Landry Matthew J, Wing Jeffrey, Albala Bruce
Department of Health, Society, and Behavior, Joe C. Wen School of Population & Public Health, University of California, Irvine, Irvine, CA, United States.
Department of Epidemiology & Biostatistics, Joe C. Wen School of Population & Public Health, University of California, Irvine, Irvine, CA, United States.
Front Public Health. 2025 Jun 18;13:1531775. doi: 10.3389/fpubh.2025.1531775. eCollection 2025.
Cardiovascular disease (CVD) is the leading cause of death, and disproportionately affects racial-ethnic groups. Community-engaged research is an important avenue to address health disparities, and understand barriers faced by vulnerable populations. This qualitative study is a sub-study of the Skills-based Educational Strategies for Reduction of Vascular Events in Orange County (SERVE OC) clinical trial (Trial ID NCT05641519), which employed focus group discussions to gain insight into community understanding of CVD within the local Latino community of Orange County. The study also aimed to identify themes of (1) community knowledge, beliefs, and attitudes toward CVD prevention, (2) barriers and facilitators to implementing a family-based intervention, and (3) community-level barriers and solutions to optimal heart health to inform the adaptation of SERVE OC's intervention. Further, this study aimed to examine subthemes for each major theme, including (1) limited CVH knowledge, cultural and gender norms, and misinformation (2) barriers to CVH, including transportation, technology, financial and work constraints; facilitators including CHW and family dynamics (3) community barriers including cost, resources, and environment; community solutions including community infrastructure and access to resources.
Fourteen focus groups ( = 69) were conducted over a 20-month period using a semi-structured interview format. Participants consisted of community family members, community health professionals, and SERVE OC clinical trial participants. Dedoose was utilized to code for thematic analysis, guided by the Social Ecological Model and Social Network Theory.
Three themes were identified: (1) Community CVD knowledge, attitudes, and beliefs; (2) Barriers and facilitators to implementing family-based interventions; and (3) the identification of structural/community level barriers along with community levels strategies to achieving optimal cardiovascular health.
Findings showed significant gaps in CVD knowledge and prevention, including understanding of nutrition and barriers to access for healthy foods. Focus groups provided insight into the critical role of familial support in health behaviors and outcomes, and barriers and facilitators for family-based interventions. These results help tailor the SERVE OC family-based intervention in real-time, allowing for a more targeted approach to addressing cardiovascular-related challenges within the Latino community. Through these community-engagement methods, SERVE OC can optimize program design and implementation, maximizing the positive impact of the CVD risk reduction initiative.
http://www.clinicaltrials.gov, NCT05641519.
心血管疾病（CVD）是主要的死亡原因，对不同种族和族裔群体的影响存在差异。社区参与式研究是解决健康差距、了解弱势群体面临的障碍的重要途径。这项定性研究是橙县血管事件减少技能教育策略（SERVE OC）临床试验（试验编号NCT05641519）的子研究，该试验采用焦点小组讨论来深入了解橙县当地拉丁裔社区对心血管疾病的认知。该研究还旨在确定以下主题：（1）社区对心血管疾病预防的知识、信念和态度；（2）实施家庭干预的障碍和促进因素；（3）社区层面影响最佳心脏健康的障碍及解决方案，以为调整SERVE OC干预措施提供参考。此外，本研究旨在考察每个主要主题的子主题，包括（1）有限的心血管健康知识、文化和性别规范以及错误信息；（2）心血管健康的障碍，包括交通、技术、经济和工作限制；促进因素包括社区卫生工作者和家庭动态；（3）社区障碍，包括成本、资源和环境；社区解决方案，包括社区基础设施和资源获取。
在20个月内采用半结构化访谈形式进行了14个焦点小组（n = 69）讨论。参与者包括社区家庭成员、社区卫生专业人员和SERVE OC临床试验参与者。在社会生态模型和社会网络理论的指导下，利用Dedoose软件进行编码以进行主题分析。
确定了三个主题：（1）社区心血管疾病知识、态度和信念；（2）实施家庭干预的障碍和促进因素；（3）确定结构/社区层面的障碍以及实现最佳心血管健康的社区层面策略。
研究结果表明，在心血管疾病知识和预防方面存在显著差距，包括对营养的理解以及获取健康食品的障碍。焦点小组讨论深入了解了家庭支持在健康行为和结果中的关键作用，以及家庭干预的障碍和促进因素。这些结果有助于实时调整SERVE OC基于家庭的干预措施，从而采用更具针对性的方法应对拉丁裔社区中心血管疾病相关挑战。通过这些社区参与方法，SERVE OC可以优化项目设计和实施，最大限度地发挥降低心血管疾病风险倡议的积极影响。
