Effectiveness of a multi-lingual telephone-based cardiovascular risk assessment for urban low-income, uninsured women in Los Angeles County

Heart disease is the leading cause of mortality and morbidity for women. For urban, low-income and uninsured women, disparities and barriers hinder increased awareness and knowledge on modifiable cardiovascular risk factors. Objective: To increase awareness of cardiovascular risk factors for urban, low-income and uninsured women in Los Angeles County. Methods: As an ongoing departmental project, a 7 language, phone-based cardiovascular risk assessment was developed and conducted. A validated pre/post test and assessment with tailored health comments on lifestyle modifications were administered. Callers with completed assessments were mailed a summary of their responses, corresponding health comments and health education material tailored to their responses. Six to ten weeks later, post-tests were administered. A two-tailed paired t-test assessed changes in awareness. With a power set at 90%, á=.05 and a mean difference of 1.308, total sample size was calculated at 16. Analysis was performed on 195 cases.

Results: An overall increase in mean awareness was seen (95%CI [0.972, 1.387]; p<0.0001). Regardless of the number of risk factors, statistically significant increases in awareness were detected. Regardless of language spoken, English (95%CI [0.183, 0.865]; p<0.0045) vs. non-English (95%CI [1.032, 1.485]; p<0.0001) increases in awareness were seen and Chinese (95%CI [1.457, 2.149]; p<0.0001); Korean (95%CI [0.576, 1.322]; p<0.0001); and Hispanic Mexican women (95%CI [1.457, 2.149]; p<0.0001) showed significant mean increases. Conclusion: As we strive to minimize disparities and barriers in a public health departmental setting, initial risk assessment results show promise in increasing awareness of cardiovascular risk factors for urban, low-income and uninsured women.