Corazón de la Familia (Heart of the Family)

摘要 西班牙裔2型糖尿病（T2 D）和心血管疾病（CVD）的风险显著较高 与非西班牙裔白人相比。2型糖尿病和心血管疾病的发病率急剧增加 随着人口老龄化和文化适应， 不健康的行为需要文化上适当的生活方式改变策略，以有效降低风险 还原大多数生活方式改变策略都侧重于个人和持续参与， 健康的行为是很少实现的。尊重西班牙裔家庭主义的文化价值， 家庭的福祉高于个人的福祉，我们建议进行以家庭为中心的干预， 该计划将家庭成员作为生活方式干预的积极参与者， T2 D或CVD。“家庭之心”是一项促进（社区卫生工作者）方案， 促进干预，整合循证教育和健康行为技能发展， 通过家庭成员参与的社会支持战略。我们将进行一项随机对照 试验采用2组设计，并比较了家庭二元集中的短期和长期影响 积极干预以个人为中心的控制条件对生物和行为T2 D和CVD风险 因素此外，我们将确定每个积极干预的二元组成员如何参与健康的 生活方式行为和对伴侣参与健康生活方式行为的支持程度影响他们的生活方式。 自己和伙伴的成果。在以社区为基础的参与性研究原则的指导下， 社区学术伙伴关系是为了满足西班牙裔居民的需求而建立的。 肯塔基州为社会文化量身定制的健康促进计划，以减少2型糖尿病和心血管疾病的风险。西班牙裔 社区伙伴全面参与了社会文化调整和试点测试的所有阶段， Corazón de la Familia干预。我们的社区-学术伙伴关系的工作成果是一个家庭 以二元为重点的干预，提供了一种独特的方法来维持健康的生活方式 行为，以减少T2 D和CVD风险在高危西班牙裔。此外，这种基于社区的干预 具有广泛实施以成功解决T2 D和CVD健康差异的巨大潜力 在美国的西班牙裔社区。

ABSTRACT Hispanics have significantly higher rates of type 2 diabetes (T2D) and cardiovascular disease (CVD) risk burden compared to non-Hispanic whites. Dramatic increases in rates of type 2 diabetes and cardiovascular disease in U.S. Hispanics are anticipated as the population ages and acculturation lends to engagement in unhealthy behaviors. Culturally appropriate lifestyle modification strategies are needed for effective risk reduction. Most lifestyle modification strategies have focused on individuals and sustained engagement in healthy behaviors is seldom achieved. Respectful of the Hispanic cultural value of familismo, prioritizing of the well-being of the family over that of the individual, we propose to conduct a family dyad-focused intervention that addresses family members as active participants in a lifestyle intervention for Hispanics with high risk for T2D or CVD. “Corazón de la Familia” (“Heart of the Family”) is a promotores’- (community health workers’) facilitated intervention that integrates evidence-based education and health behavior skills development with social support strategies through the involvement of family members. We will conduct a randomized controlled trial using a 2-group design and compare the short-term and long-term impact of the family dyad-focused active intervention to an individual-focused control condition on biological and behavioral T2D and CVD risk factors. Furthermore, we will determine how each active intervention dyad member’s engagement in healthy lifestyle behaviors and level of support for their partner’s engagement in healthy lifestyle behaviors affects their own and their partner’s outcomes. Guided by community-based participatory research principles, our community-academic partnership was formed in response to needs recognized by Hispanic residents of Kentucky for socioculturally tailored health promotion programs to reduce T2D and CVD risk. Hispanic community partners have been integrally involved in all phases of sociocultural tailoring and pilot testing the Corazón de la Familia intervention. The result of the work of our community-academic partnership is a family dyad-focused intervention that provides a unique approach to sustain engagement in healthy lifestyle behaviors to reduce T2D and CVD risk among at-risk Hispanics. Further, this community-based intervention has significant potential for broad implementation to successfully address T2D and CVD health disparities across U.S. Hispanic communities.