A HEART HEALTHY ACTION PROGRAM FOR PUERTO RICAN ADULTS

心血管疾病（CVD）是西班牙裔美国人死亡的主要原因。与任何其他种族相比，他们有不成比例的心脏代谢风险负担，这与其他生理、生物和社会心理压力因素相结合，导致不同的心脏健康。心血管疾病发病率的积极变化主要归因于生活方式的习惯。然而，健康促进战略只关注个人，长期成功有限。为了影响健康行为的改变和促进可持续的健康生活方式，需要一种社会生态学的健康促进方法来影响个人、社会、文化和环境层面的行为。因此，我们建议开展参与性社区干预，对影响波多黎各成年人（45-60岁）健康行为的多个层面进行干预。我们的目标是波多黎各人，因为他们代表了美国第二大西班牙裔群体。通过波士顿波多黎各人口健康和健康差异中心目前的工作，我们已经记录了一系列社会人口、生物和心理社会因素，这些因素使这一人群比其他群体面临更大的风险。我们认为参与性研究和社区参与有助于制定和实施有效的多层次心脏健康行动计划（HAP）。将通过焦点小组和关键信息提供者访谈来了解HAP的发展情况。方案组成部分（营养、体育活动、减轻压力/焦虑和社会支持）将通过多层次的活动（个人、社会、文化和环境）来解决。HAP健康行为信息和咨询将通过使用计算机参与工作联盟的创新技术得到加强。我们组建了一个跨学科专家小组，由营养、体育活动、心理学、计算机科学、社会科学、流行病学、公共卫生和医学等方面的专家组成，他们计划共同努力，解决生活在波士顿大都会市区服务不足的弱势波多黎各成年人之间的心脏健康差距。我们的长期目标是建立一个有效和可持续的心脏健康促进计划，可以在有风险的人群中广泛实施。

Cardiovascular disease (CVD) is the leading cause of death among Hispanics. They have a disproportionate cardio-metabolic risk burden compared to any other ethnic group, which combined with other physiological, biological, and psychosocial stressors, contribute to disparate heart health. Positive changes in CVD morbidity are largely attributed to lifestyle practices. However, health promotion strategies have focused merely on individuals with limited long-term success. In order to influence health behavior change and promote sustainable healthy lifestyles, a socio-ecologic approach of health promotion is needed to influence behavior at the individual, social, cultural, and environmental levels. Therefore, we propose to conduct a participatory community-based intervention to intervene on each of these multiple levels that influence health behavior in Puerto Rican adults (45-60 years). We target Puerto Ricans because they represent the second largest Hispanic sub-group in the US. We have documented, through current work fi-om the Boston Puerto Rican Center on Population Health and Health Disparities, a constellation of sociodemographic, biological and psychosocial factors that place this population at a greater risk than other groups. We hj^othesize that participatory research and community engagement wall help develop and implement an effective multi-level Heart Healthy Action Program (HAP). HAP development vnll be informed through focus groups and key informant interviews. Program components (nutrition, physical activity, stress/anxiety reduction and social support) wdll be addressed by multi-level activities (individual, social, cultural and environmental). HAP health behavior messages and counseling will be re-enforced through innovative technology using computer-participant working alliances. We have assembled a trans-disciplinary team of experts in nutrition, physical activity, psychology, computer science, social science, epidemiology, public health and medicine, who plan to work jointly to address heart health disparities among under-served disadvantaged Puerto Rican adults living in the Metro-Boston urban area. Our long-term goal is to create an effective and sustainable heart health promotion program that could be implemented broadly in populations at risk.