Improving heart healthy lifestyles among participants in a Salud para su Corazón promotores model: the Mexican pilot study, 2009-2012

Abstract

Introduction: In Mexico, cardiovascular disease and its risk factors are growing problems and major public health concerns. The objective of this study was to implement cardiovascular health promotion and disease prevention activities of the Salud para su Corazón model in a high-risk, impoverished, urban community in Mexico City.

Methods: We used a pretest-posttest (baseline to 12-week follow-up) design without a control group. Material from Salud para su Corazón was validated and delivered by promotores (community health workers) to community members from 6 geographic areas. Two validated, self-administered questionnaires that assessed participants' knowledge and behaviors relating to heart health were administered. We used t tests and χ(2) tests to evaluate pretest and posttest differences, by age group (≤60 and >60 years), for participants' 3 heart-healthy habits, 3 types of physical activity, performance skills, and anthropometric and clinical measurements.

Results: A total of 452 (82%) adult participants completed the program. Heart-healthy habits from pretest to posttest varied by age group. "Taking action" to modify lifestyle behaviors increased among adults aged 60 or younger from 31.5% to 63.0% (P < .001) and among adults older than 60 from 30.0% to 45.0% (P < .001). Positive responses for cholesterol and fat consumption reduction were seen among participants 60 or younger (P = .03). Among those older than 60, salt reduction and weight control increased (P = .008). Mean blood glucose concentration among adults older than 60 decreased postintervention (P = .03).

Conclusion: Significant improvements in some heart-healthy habits were seen among adult participants. The model has potential to improve heart-healthy habits and facilitate behavioral change among high-risk adults.

Figure 1

Distribution of responses for heart-healthy habits among adult participants at baseline (pretest) and 12-week postintervention follow-up (posttest) in the Salud para su Corazón Mexican pilot study. Responses were positive if the respondent answered yes for improved (less salt, saturated fat, and cholesterol consumption, more weight control or weight reduction) or “sometimes” improved on some days but not all the time. Negative responses if the respondent answered “no” meaning the positive health behavior is the same or decreasing (such as more or same amount of salt intake or cholesterol and fat consumption, less weight control or weight gain). [Table: see text]

Figure 2

Percentage of positive responses about various physical activities among participants from baseline (pretest) to 12-week post-intervention follow-up (posttest) in the Salud para su Corazón Mexican pilot study. Physical activities were reported as percentage of time doing the following: using stairs, using the bus and walking, walking, gardening, or performing 3 types of exercise: type A (exercised 10 minutes, 3 times/day, some days of the week), type B (exercised 30 minutes/d, some days of the week), and type C (exercised 30 minutes/d, ≥3 times/week). [Table: see text]