CHWs Promote Heart Health in Low-Resource Communities in Latin America

Background: Cardiovascular disease (CVD) is the leading cause of death in the Americas. Evidence reveals increased CVD risk factors in all countries including overweight, hypertension, smoking, diabetes, and lack of physical activity. The National Heart, Lung, and Blood Institute (NHLBI) and the Pan American Health Organization (PAHO) are collaborating to address this public health challenge. Following a workshop on the feasibility of using the CHW model to promote health in the Americas, the NHLBI and PAHO funded three projects to plan, implement, and evaluate interventions led by trained CHWs to promote heart health in low-resource communities in Argentina, Chile, and Guatemala (2007 to 2010). Methods: Project teams, trained on the use of NHLBI's Your Heart, Your Life (Su corazón, su vida) Manual, used qualitative methods to adapt the manual to the realities of each site; a pre and post-test was utilized to measure changes in knowledge, attitudes, and behaviors (KABs) among trained CHWs and community members who participants in the interventions. Qualitative methods were used to identify promising community engagement and partnership approaches to assure sustainability.

Results: The projects demonstrated the feasibility of adapting CHW training tools designed for Latino audiences in the United States, and identified methods to mobilize community resources and engage community members to adopt healthy behaviors.

Conclusions: KAB's for heart healthy behaviors significantly increased among trained CHWs and community members who participated in CHW-led interventions, suggesting that training CHWs enhances their ability to provide heart health information and influence community members to adopt healthy behaviors.