| A culturally sensitive bilingual nutrition cardiovascular disease (CVD) risk reduction educational program for Hispanics was developed. The program development was theory driven and involved five studies. In Study I, the Expanded Food and Nutrition Education Program (EFNEP) curricula was assessed and revised for low literacy, cultural sensitivity for Mexicans and Puerto Ricans, and for its emphasis on CVD risk reduction through the Food Guide Pyramid. To assess this revised curricula, culturally appropriate surveys that measured the knowledge of Hispanics, their attitudes, subjective norms, and behaviors concerning CVD risk were developed (Study II). Additional surveys piloted for the audience were an acculturation scale, Spanish and English literacy tests, and a food frequency questionnaire. In Study III, the CVD nutrition curricula and the surveys were pilot-tested with a group of Hispanics from English as a Second Language classes. Many salient barriers which were not content related made this pilot-test unsuccessful, suggesting that curricula in the EFNEP model couldn't be applied to other community settings. Subsequently, two additional studies were conducted concurrently: a new pilot-test of the curricula with EFNEP participants (Study IV) and a qualitative study of the health beliefs of Mexicans vs. Caucasians concerning CVD (Study V). In Study IV, the CVD nutrition and the unmodified EFNEP curricula were administered to 72 Hispanics from Illinois. Both groups increased their positive attitudes and knowledge concerning healthy diets. In Study V, 16 Mexican low-acculturated and 15 non-Hispanic white women of similar age and low education level, and with internal locus of control participated in individual in-depth open ended-standardized interviews about their health beliefs and attitudes concerning CVD, culture, social marketing, and other health topics. The results suggest that radio and television may provide important educational avenues for reaching Hispanic groups. Both women's groups had a lack of knowledge about CVD, about the relationship of food and CVD, and about the relationship of diet, health and illness, and weight. Mexican women had a lack of knowledge about basics of anatomy and physiology. |
