Corazón de la Familia (Heart of the Family)

Hispanics have significantly higher rates of type 2 diabetes and cardiovascular disease risk burden compared to non-Hispanic whites. Dramatic increases in rates of type 2 diabetes and cardiovascular disease in the U.S. Hispanic population are anticipated as the population ages and acculturation lends to engagement in unhealthy behaviors. Culturally appropriate lifestyle modification strategies are needed for effective risk reduction. Most lifestyle modification strategies have focused on individuals and sustained engagement in healthy behaviors is seldom achieved. Respectful of the Hispanic cultural value of familismo, prioritizing of the well-being of the family over that of the individual, we propose to conduct a family-focused intervention that addresses family members as active participants in a lifestyle intervention for Hispanics with high risk for type 2 diabetes or cardiovascular disease. “Corazón de la Familia” (“Heart of the Family”) is a promotores’- (community health workers’) facilitated intervention that integrates evidence-based education and health behavior skills development with social support strategies through the involvement of family members. We will compare the short-term and long-term impact of the Corazón de la Familia to a usual care intervention on biological and behavioral T2D and CVD risk factors by conducting a randomized controlled trial with Hispanic family dyads using a 2-group design (Corazón de la Familia intervention versus usual care). Furthermore, we will determine how each dyad member’s engagement in healthy lifestyle behaviors and level of support for their partner’s engagement affects their own and their partner’s health outcomes. Guided by community-based participatory research principles, our community-academic partnership was formed in response to needs recognized by Hispanic residents of Kentucky for socioculturally tailored health promotion programs to reduce type 2 diabetes and cardiovascular disease risk. Hispanic community partners have been integrally involved in all phases of sociocultural tailoring and pilot testing the Corazón de la Familia intervention. The result of the work of our community-academic partnership is a family-focused intervention that provides a unique approach to sustain engagement in healthy lifestyle behaviors to reduce type 2 diabetes and cardiovascular disease risk among at-risk Hispanics. Further, this community-based intervention has significant potential for broad implementation to successfully address type 2 diabetes and cardiovascular disease health disparities across U.S. Hispanic communities.