Pasos Adelante: A community based intervention for chronic disease prevention for Latino populations

The Pasos Adelante/Steps Forward program is a community-based intervention in the border city of Douglas, Arizona (population 17,000). The curriculum was designed to improve knowledge and support individuals in making meaningful changes in their lifestyles that may, over time, result in improved health. The curriculum was developed as an adaptation of the NHLBI Su Corazón Su Vida curriculum as part of the Border Health Strategic Initiative. The curriculum consists of 12 two-hour educational sessions facilitated by community health workers/promotoras plus weekly walking groups. The curriculum includes information on risk for diabetes and heart disease, maintaining a healthy weight, healthy eating, living smoke free, and becoming more physically active. Participants have 32 opportunities to walk with other participants in a walking group. To date, we have recruited 313 individuals and 211 have completed pre-intervention, post-intervention, and follow-up (3 month post-intervention) measurements. These individuals have a mean age of 50 years, are predominantly female (92%), Hispanic (99%), prefer to speak (89%) and read (90%) Spanish, and were born in Mexico (87%). There was a statistically significant decrease in mean waist circumference (94.4 ± 13.5 cm versus 90.9 ± 13.3 cm; p < 0.0001) and BMI (31.4 ± 6.0 kg/m2 versus 31.2 ± 6.0 kg/m2; p < 0.0001) after the intervention period. Analyses of other risk factors showed similar results. Thus, this promotora based curriculum was successful in improving lifestyle characteristics that may lead to improved health outcomes.