Community health workers coach low-income Latino residents of East L.A. to reduce their risk of heart disease by adopting the MyPlate.gov high-satiation lifestyle recommendations

Heart disease is the #1 killer of women.  Residents of East Los Angeles are 85% Mexican American, mostly immigrant, low-income and Spanish-speaking. Obesity, an important contributor to heart disease, is unusually prevalent in East L.A.  140 residents (87% female) were randomly assigned to two conditions.  One was a multilevel, community-based lifestyle change intervention.  The intervention was designed to reduce their heart disease risk by promoting adherence to MyPlate.gov nutrition recommendations and to the Physical Activity Guidelines for Americans. It included 18 health education sessions between trained community health workers (“promotores”) and residents identified as being at high risk of heart disease.  Using their familiarity with community norms and practices, the CHWs tailored the intervention for optimal community receptivity.  The in-home sessions included recommended changes to the home environment, such as moving the TV out of the dining area and hiding the sugary beverages behind cabinet doors.  Reconfiguring family routines was also discussed, with the goal of encouraging more family meals, limiting daily TV watching, and encouraging fruits and vegetables at every meal.  The telephone coaching sessions and especially the in-home sessions were greatly facilitated by having as intervenors recognizable members of the community who experienced the same economic constraints as the residents.   The CHWs were particularly helpful in linking study participants to community resources that would facilitate their adherence to federal lifestyle recommendations.  Because of their high standing in the community, they also proved to be exceptional in recruiting study participants and excelled at retaining participants throughout the trial.