salud comunitaria

"if the major determinants of health are social, so must be the remedies" Michael Marmot

Disminuir el riesgo cardiovascular con intervenciones comunitarias

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vía @hlth_Literacy

Un estudio muy interesante, realizado con una metodología de Community-Based Participatory Research (Investigación Participativa Orientada a la Comunidad) en la zona de frontera de El Paso (Texas). El objetivo del Proyecto HEART (Health Education Awareness Research Team) desarrollado conjuntamente por diferentes instituciones (universidad, una clínica comunitaria para personas sin acceso a otro tipo de cobertura sanitaria y agentes sociales y comunitarios) para mejorar los comportamientos saludables y disminuir los factores de riesgo cardiovascular en una población hispana de alto riesgo en la zona de la frontera de México y Estados Unidos.

Balcázar HG, de Heer H, Rosenthal L, Aguirre M, Flores L, Puentes FA, et al. A promotores de salud intervention to reduce cardiovascular disease risk in a high-risk Hispanic border population. Prev Chronic Dis 2010;7(2).
The high prevalence of cardiovascular disease (CVD) in the Hispanic population of the United States, together with low rates of health insurance coverage, suggest a potential cardiovascular health crisis. The objective of Project HEART (Health Education Awareness Research Team) was to promote behavior changes to decrease CVD risk factors in a high-risk Hispanic border population.

Methods
Project HEART took place from 2005 through 2008 as a randomized community trial with a community-based participatory research framework using promotores de salud (community health workers). A total of 328 participants with at least 1 CVD risk factor were selected by randomizing 10 US Census tracts in El Paso, Texas, to either the experimental or the control group. The experimental group (n = 192) was assigned to a series of 8 health classes using the Su Corazón, Su Vida curriculum. After 2 months of educational sessions, the group was followed for 2 months. The control group (n = 136) was given basic educational materials at baseline, and no other intervention was used. Main outcomes of interest included changes in health behaviors and clinical measures.

Results
Participants in the experimental group showed more awareness of CVD risk factors, more confidence in the control of these factors, and improved dietary habits (ie, lower salt and cholesterol intake, better weight-control practices) compared with the control group. Total cholesterol was 3% lower in the experimental than in the control participants, and non–high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were both 5% lower.

Conclusion
The HEART trial suggests that community health education using promotores de salud is a viable strategy for CVD risk reduction in a Hispanic border community.

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