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

项目摘要 中风和心血管疾病占美国拉丁美洲人死亡人数的四分之一，心脏病是 第二大死因加州南部的越南人的发病率一直很高 高血压与中风发病率升高有关。高血压不成比例地影响有色人种社区 由于基于种族的居住隔离，这些人往往在居住地集中。在社会上撤资， 有色人种社区的经济和物理环境增强了心血管疾病风险的障碍 预防和管理。这些差异，沿着不同人口的持续增长， 加州南部和整个美国，强调需要新的、社区一级的干预措施， 高血压高血压的一级预防对于实现以下目标至关重要： 理想的心血管健康所有心血管健康。越来越多的证据表明， 将社交网络转化为行为干预措施，可以提高 降低血管风险。橙子县减少血管事件的技能教育策略 （服务OC）干预是一个文化定制的，以技能为基础的教育计划， 家庭结构和利用社区卫生工作者模式。我们的假设是，这种方法将 优化成功的长期行为改变，以预防成人和儿童的高血压， 加利福尼亚州橙子县的越南和拉丁美洲家庭。这一假设得到了重要的支持。 形成性研究，包括我们最初的减少血管事件的出院教育策略 （DESERVE）干预随机对照试验。DESERVE改变了降低血管风险的范式 通过将信息转化为基于技能的行动， 收缩压总体和统计学显着降低收缩压拉丁美洲人。 DESERVE还发现，在那些得到更强支持的人中， 网络.这项建议旨在与SERVE OC一起测试我们是否可以通过调整优化 通过使用家庭网络作为平台来提供降压的DESERVE干预模式 高血压的一级预防。

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.