Graduation Year

2020

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Public Health

Major Professor

Ismael Hoare, Ph.D.

Co-Major Professor

Liliana Rodriguez-Campos, Ph.D.

Committee Member

Jaime Corvin, Ph.D.

Committee Member

Dinorah Martinez Tyson, Ph.D.

Committee Member

Robert Dedrick, Ph.D.

Keywords

community health workers, health program, health promotion, cardiovascular disease

Abstract

Su Corazόn, Su Vida (Your Heart, Your Life) is a community-based, small-group health intervention designed to empower Latinos to enhance cardiovascular disease awareness and initiate enduring lifestyle changes to improve health outcomes and quality of life. Originally developed to be delivered in weekly sessions in Spanish or English language, it addresses several heart disease risk factors including unhealthy eating habits, poor physical activity, high cholesterol, overweight, metabolic syndrome, diabetes and tobacco smoking, among others. Instructors use diverse learning and support strategies such as group discussion, role modeling, problem-solving, health action planning, and self-monitoring. Participants help each other to stay on track by making weekly pledges and reporting on them to the class the week after. Course materials include bilingual flip-charts, activity handouts, the Act in Time to Heart Attack Signs video, and the instructor manual. Program facilitators are usually community members who received the curriculum and then became promotores de salud using the train-the-trainer model. While the program has proven to be effective, there have been few publications examining the lived experiences of participants during the training and facilitation processes. Both quantitative and qualitative methods were employed in this research study, whose primary purpose was to understand participants’ perceptions while being trained and then teaching Su Corazόn, Su Vida in Spanish to other community members. Findings were informed by tenets from the PRECEDE-PROCEED model (PPM) and the social cognitive theory (SCT), including implementation barriers and facilitators potentially affecting program engagement and promotores’ self-efficacy. The secondary purpose of this study was to compare changes in heart health knowledge outcomes in newly trained promotores and community members receiving Su Corazόn, Su Vida from them, by using a validated test based on the program’s curriculum. For both groups, the 23-item pretest was found to be reliable and internally consistent, with a Cronbach’s α of .810. The 23-item post-test had a Cronbach’s α of .783. A total of 20 Latino participants were recruited to attend five 2-hour training sessions, followed by program facilitation with a similar schedule. Seventeen promotores completed the training, of whom 16 completed the pretest/post-test, taught the program and underwent in person, in-depth interviews at the end. Thirty-two community members receiving the program from promotores also completed the pretest/post-test. Results from the quantitative confirmatory phase indicated that there was significant increase in heart health knowledge acquisition after the intervention was delivered in promotores (t(15)= 3.967, p=

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