UCLA-UCI Center for Eliminating Cardio-Metabolic Disparities in Multi-Ethnic Populations

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PROJECT SUMMARY Stroke and cardiovascular disease account for 1 in 4 deaths among Latinos in the U.S, and heart disease is the second leading cause of death overall. Vietnamese populations in southern CA have persistently high rates of hypertension linked to elevated rates of stroke. Hypertension disproportionately affects communities of color who are often concentrated residentially due to race-based residential segregation. Disinvestment in the social, economic, and physical environment in communities of color enhances barriers to cardiovascular disease risk prevention and management. These disparities, along with the continued growth of diverse populations in southern California and across the U.S., highlight the need for novel, community-level interventions to prevent hypertension. Primordial prevention of hypertension is critical in moving forward in terms of the achievement of ideal cardiovascular health cardiovascular health for all. There is growing evidence that integrating families and social networks into behavioral interventions may enhance the efficacy, effectiveness and sustainability of vascular risk reduction. The Skills-based Educational strategies to Reduce Vascular Events in Orange County (SERVE OC) intervention is a culturally-tailored, skills-based educational program set within a supportive family structure and utilizing a community health worker model. Our hypothesis is that this approach will optimize successful long-term behavioral change for prevention of hypertension among adults and children in Vietnamese and Latino households in Orange County, CA. This hypothesis is supported by significant formative research, including our original Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention randomized control trial. DESERVE shifted the paradigm for vascular risk reduction strategies by translating information to skills-based actions resulting in a clinically significant reduction in systolic blood pressure overall and a statistically significant reduction in systolic blood pressure among Latinos. DESERVE also found that blood pressure reduction was enhanced among those with stronger support networks. This proposal seeks to test with SERVE OC whether we can optimize, through adaptation, the DESERVE intervention model for blood pressure reduction by using family networks as a platform to deliver primary prevention of hypertension.