Efficacy of Behavioral Interventions on Biological Outcomes for Cardiovascular Disease Risk Reduction among Latinos: a Review of the Literature

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among Latinos. Designing and delivering culturally appropriate interventions are critical for modifying behavioral and nutritional behavior among Latinos and preventing CVD. OBJECTIVE: This literature review provides information on evidence-based behavioral intervention strategies developed for and tested with at risk Latinos, which reported impacts on biological outcomes. METHODS: A literature search was performed in PubMed that identified 110 randomized controlled trials of behavioral interventions for CVD risk reduction with at risk Latinos (≥ 1 CVD risk factor, samples > 30% Latino), 4 of which met the inclusion criteria of reporting biological outcomes (BP, Cholesterol, LDL, HDL, and BMI). RESULTS: All the studies used promotoras(Hispanic/Latino community member with training that provides basic health education in the community without being a professional healthcare worker) to deliver culturally appropriate interventions that combined nutritional and physical activity classes, walking routes and/or support groups. One study reported statistically significant reductions in systolic blood pressure, and an increase in physical activity. One study reported reductions in cholesterol levels compared to the control group. Two studies did not have significant intervention effects. Most studies demonstrated no significant changes in LDL, HDL or BMI. Methodological limitations include issues related to sample sizes, study durations, and analytic methods. CONCLUSION: Few studies met the inclusion criteria, but this review provides some evidence that culturally appropriate interventions such as using promotoras, bilingual materials/classes, and appropriate cultural diet and exercise modifications provides potentially efficacious strategies for cardiovascular risk improvement among Latinos