We propose to promote cardiovascular health through nutritional education to a low literacy Population enrolled in English as a Second Language (ESL) courses in San Diego Community College District. 1,800 students in 90 different classes will be randomly assigned to the special nutritional intervention or an attention-control condition where a certification course in cardiopulmonary resuscitation (CPR) will be taught. Specially trained ESL teachers will actually lead the intervention classes, which will be designed in accordance with NHLBI and American Red Cross guidelines, respectively. Specific educational content for the intervention group will include sources of dietary fat and cholesterol nutrients affecting blood pressure, basic shopping skills, food preparation skills , and dealing with special occasions, i.e., potlucks. A booster session will be held to monitor progress, provide reinforcement for success or additional problem solving for difficulties, review materials, and plan maintenance. Consistent with a Social Learning (Cognitive) Theory (SLT) framework, all sessions will include modeling*, role playing, corrective feedback and social reinforcement, homework, and confidence building activities. With attention to the specific needs of this population which is low in literacy (at least in English), the smallest amount of information necessary will be presented, each point will be made as vividly as possible, participants will restate and otherwise demonstrate their mastery of the material, and frequent repetition will be used. A substantial period of formative research will emphasize specific adaptations of existing material to make' it appropriate for this population. Measurement will occur at baseline, at 3 months and at a 6 months follow up. Measures will include blood pressure, total cholesterol, height/weight, waist and hip circumference, 24-hour dietary recall, SLT-based knowledge, attitude and behavior variables, the Comprehensive Adult Student Assessment System (CASAS) Life Skills Reading Test and Spanish literacy through the Cloze technique. All self-report measurement except the CASAS will be conducted in English or Spanish, primarily through oral interview. SLT knowledge, attitude, and behavioral measures of instructors in study and non-study classes will also be assessed.
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