Corazón de la Familia (Heart of the Family)

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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.