We propose a UCLA-USC community-based randomized controlled trial of a home environment intervention involving families in East Los Angeles, a predominantly Mexican-American community at high risk of metabolic syndrome-related cardiovascular disease. The interveners will be trained community workers (promotoras). This multilevel intervention is designed to reduce vascular stiffness, an early-in-life biomarker of cardiovascular risk;one that is sensitive to lifestyle intervention. 240 families with a family member recently diagnosed with diabetes will be enrolled in the study. Half will be randomized to the Family Environment Cardiovascular Disease Risk Reduction program, the other half to the Family Cancer Early Detection attention-control condition. The promotoras will provide up to 16 counseling sessions to a designated adult family member without diabetes. The sessions will focus on improving the home environment by reducing TV viewing opportunities, increasing fruit and vegetable availability, decreasing access to refined carbohydrates, assuring access to a scale to monitor body weight and increasing access to exercise equipment Lifestyle change goals will be consistent with the Dietary Guidelines for Americans, especially the DASH diet and 30 minutes of daily moderate physical activity, but tailored to the family's capacity to change. Four group health education sessions include atour of a make-over comer store participating in Project #3 of this program project. Local farmers market coupons will be given as incentives for each counseling and group health education session. Self-report, diet and cardiovascular disease biomarkers will be collected at baseline, 6 months, 12 months and 24 months follow-up. Retention is expected to be 90% over 12 months and 85% over 24 months, based on the investigators'past experience with this population. The primary outcomes will be two measures of arterial stiffness. Secondary outcomes will include the consensus features of the metabolic syndrome and community-level moderators of cardiovascular risk, including walkability and density of fast food restaurants in the census tracts in which the study participants reside, which are expected to influence the sustainability of the intervention impact.

Public Health Relevance

This study evaluates the impact on vascular function of a program designed to get predominantly Mexican American families at high risk of metabolic syndrome to make their home environments more supportive of healthful lifestyle practices and to take advantage of community assets, such as health-minded corner stores, to sustain healthy eating and physical activity levels. Reduction in heart disease should result

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Specialized Center (P50)
Project #
5P50HL105188-04
Application #
8470703
Study Section
Special Emphasis Panel (ZCA1-SRLB-3)
Project Start
Project End
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
4
Fiscal Year
2013
Total Cost
$478,801
Indirect Cost
$70,164
Name
University of California Los Angeles
Department
Type
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Alcalá, Héctor E; Albert, Stephanie L; Trabanino, Shawn K et al. (2016) Access to and Use of Health Care Services Among Latinos in East Los Angeles and Boyle Heights. Fam Community Health 39:62-71
Hohl, Sarah D; Thompson, Beti; Krok-Schoen, Jessica L et al. (2016) Characterizing Community Health Workers on Research Teams: Results From the Centers for Population Health and Health Disparities. Am J Public Health 106:664-70
Langellier, Brent A; Chen, Jie; Vargas-Bustamante, Arturo et al. (2016) Understanding health-care access and utilization disparities among Latino children in the United States. J Child Health Care 20:133-44
Chen, Jie; Vargas-Bustamante, Arturo; Mortensen, Karoline et al. (2016) Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act. Med Care 54:140-6
Alcalá, Héctor E; Albert, Stephanie L; Ortega, Alexander N (2016) E-cigarette use and disparities by race, citizenship status and language among adolescents. Addict Behav 57:30-4
Gill, Monique; Chan-Golston, Alec M; Rice, Lindsay N et al. (2016) Consistency of Moderate to Vigorous Physical Activity in Middle School Physical Education. Fam Community Health 39:283-92
Ortega, Alexander N; Albert, Stephanie L; Chan-Golston, Alec M et al. (2016) Substantial improvements not seen in health behaviors following corner store conversions in two Latino food swamps. BMC Public Health 16:389
Alcalá, Héctor E; Sharif, Mienah Z; Albert, Stephanie L (2016) Social cohesion and the smoking behaviors of adults living with children. Addict Behav 53:201-5
Cavallo, David N; Horino, Masako; McCarthy, William J (2016) Adult Intake of Minimally Processed Fruits and Vegetables: Associations with Cardiometabolic Disease Risk Factors. J Acad Nutr Diet 116:1387-94
Smith, Caren E; Fullerton, Stephanie M; Dookeran, Keith A et al. (2016) Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities. Health Aff (Millwood) 35:1367-73

Showing the most recent 10 out of 49 publications