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

项目总结 在美国，中风和心血管疾病占拉美裔死亡人数的四分之一，心脏病是 总体上是第二大死因。南加州的越南人口比例持续居高不下 高血压与中风发病率的升高有关。高血压对有色人种群体的影响不成比例 由于基于种族的居住隔离，他们往往集中居住在一起。取消对社会领域的投资， 有色人种社区的经济和自然环境增强了心血管疾病风险的障碍 预防和管理。这些差距，以及多样化人口的持续增长 南加州和全美强调需要新颖的社区层面的干预措施来预防 高血压。高血压的原始预防是取得以下成就的关键 理想的心血管健康所有人的心血管健康。越来越多的证据表明，融合家庭和 将社会网络纳入行为干预可能会增强 降低血管风险。奥兰治县减少血管事件的技能教育策略 (为OC服务)干预是一种根据文化定制的、基于技能的教育计划，设置在支持性 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预防成人和儿童高血压 加利福尼亚州奥兰治县的越南和拉丁裔家庭。这一假设得到了显著的支持 形成性研究，包括我们独创的减少血管事件的出院教育策略 (值得)干预随机对照试验。值得改变降低血管风险的范例 通过将信息转化为基于技能的行动的策略，导致临床上显著减少 总体收缩压和拉丁裔的收缩压有统计学意义的降低。 沃思还发现，在那些支持度更高的人中，血压的降低幅度更大 网络。这项建议旨在与服务业主立案法团一起测试我们是否可以通过适应来优化 以家庭网络为平台开展降压干预的值得模式 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.