A potentially effective way for recent US immigrants to learn about heart disease prevention may be in the English-as-a-second-language (ESL) classroom environment, according to a study that focused on San Diego, CA-based Latino immigrants.
"The ESL environment presents an ideal avenue for reaching immigrants and others with limited English proficiency, since people in these classes can be considered to be relatively motivated to improve both their general knowledge and their specific English language abilities," said lead author John P. Elder, PhD, MPH, of San Diego State University in California.
More than half of US minority populations are classified as functionally illiterate. Members of these groups experience difficulty complying with medical advice and suffer reduced access to public health messages, according to the study.
Elder and colleagues enlisted Latino ESL students in the San Diego area to take a series of three-hour classes on heart health and nutrition. The classes covered topics such as fat and cholesterol, eating habits, food labels, and blood pressure, and were designed for adults with limited English skills.
The researchers enlisted another group of Latino ESL students to serve as a comparison group. This group took a series of stress management classes instead of the heart-health classes. Elder and colleagues took blood pressure, cholesterol, waist and hip, and weight measurements of all study participants at the start of the study period.
Three months later, the cholesterol and blood pressure measurements, as well as nutrition knowledge and fat-avoidance behavior, of the students who took the heart-health classes had improved relative to the comparison group, the researchers found.
But some gains made by the heart-health group did not persist. After six months they remained superior to the comparison group only in terms of nutrition knowledge and fat avoidance. The comparison group had caught up to the heart-health group in terms of cholesterol and blood pressure improvements.
The researchers posited several possible causes for the convergence between the two groups. These included the possibilities that individuals who took heart-health classes may have shared what they learned with others in the comparison group, or teachers of the stress management classes may have incorporated heart-health principles into their classes.
Cardiovascular disease rates are currently lower among Latino immigrants - who made up nearly 10 percent of the US population in 1990 - than among native-born Americans, but this trend is expected to change, according to Elder.
"Cardiovascular disease is the greatest killer of Latinos in the United States, and as this population assimilates, morbidity and mortality rates are likely to approximate those of the rest of the population," he said.
Elder and colleagues' results appear in the February issue of Health Education & Behavior. Their study was part of a federally-funded effort to prevent heart disease in low-literacy populations.
"Results from this study at a minimum point to the receptivity of the ESL students and teachers to heart-health promotion," said Elder.
"They also demonstrate a method of reaching a population that does not traditionally have access to public health messages due to activities that compete for their time, such as work, school, and family, or other barriers," Elder concluded.
This research was supported by a grant from the National Heart, Lung, and Blood Institute.
Health Education & Behavior, a bimonthly peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. SOPHE is an international, non-profit professional organization that promotes the health of all people through education.
For information about the journal, contact Elaine Auld at 202-408-9804.
Posted by the Center for the Advancement of Health http://www.cfah.org. For information about the Center, call Petrina Chong, pchong@cfah.org 202-387-2829.
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Health Education & Behavior