New York University School of Medicine, Center for the Study of Asian American Health (NYU CSAAH)
NYU CSAAH condensed the curricula into four community sessions taught by community health workers:
- The first session focused on assessing heart disease risk and recognizing heart attack signs.
- The second focused on physical activity, weight management, and blood pressure control.
- The third addressed control of cholesterol and diabetes.
- The final session taught participants about nutrition and living smoke free.
San Diego and San Francisco, CA; and Hudson County, NJ
Kalusugan Coalition, Inc., Pan-American Concerned Citizens Action League, Filipino Community Cancer Collaborative, Kalusugan Community Services, Project AsPIRE
Studies conducted among Filipino Americans living in the United States indicate that they experience a disproportionately higher burden of hypertension than do whites or other Asian Americans, Native Hawaiians, and Pacific Islanders. Hypertension prevalence rates range from 26.6 percent to 65.2 percent.1-6 Despite these findings, few interventions have focused on controlling hypertension or other risk factors for cardiovascular disease in Filipino Americans. A large body of research has demonstrated that community health workers (CHW) are effective in improving chronic disease and health outcomes, but little CHW research has focused on Asian and Pacific Islander communities.
NYU CSAAH developed the Alliance of Filipino American Community Health Workers to enhance CHW training, networking, and capacity building across the country. The Alliance initiative used a train-the-trainer model that was developed with community input to ensure its cultural and linguistic relevance. The model aimed to help participants control high blood pressure, cardiovascular disease, and stroke through a CHW intervention. In light of the high concentration of Filipino Americans on both coasts, the Alliance chose to launch a bicoastal outreach project.7
Through its partnerships, the Alliance used the Healthy Heart, Healthy Family curricula to train 48 CHWs, who then reached out to 199 Filipino Americans with education tailored to heart disease prevention needs. The Alliance ensured that the CHWs had the skills and support to implement the NHLBI’s programs using tools such as webinars, online toolkits, and social media. Training also included CHW core competencies, culturally tailored to the Filipino American community: education, communication, and outreach strategies; legal and ethical responsibilities; coordination, documentation, and reporting strategies; advocacy; and clinical measurement and hypertension control strategies.
Community participants were encouraged to attend four CHW-led monthly 90-minute group educational sessions that provided the tools and strategies that they needed to promote heart health to fellow Filipino American individuals, families, and communities. Instructional and coaching videos showing interactive activities were created and posted online.
NYU used the NHLBI’s pre- and post-test surveys with CHWs and community members to assess changes in heart health knowledge, attitudes and beliefs. Additional measures were collected via partner sites’ quarterly reports, CHW-led trainer “training notes,” and fidelity checklists. Key-informant interviews with partners and community members were used to assess the development of the national network, CHWs’ use and satisfaction of the heart health materials, and their training and support. CHWs created video logs to document participants’ perspectives on their learning experiences, what worked best, and suggestions for improvements.
1 Ursua, R. A., Islam, N. S., Aguilar, D. E., Wyatt, L. C., Tandon, S. D., Abesamis-Mendoza, N.,…Trinh-Shevrin, C. (2013). Predictors of hypertension among Filipino immigrants in the Northeast. U.S. Journal of Community Health. doi: 10.1007/s10900-013-9689-6
2 Klatsky, A. L., Tekawa, I. S., & Armstrong, M. A. (2000). Cardiovascular risk factors among Asian Americans. Public Health Reports, 111(Suppl 2), 62-64.
3 Ryan, C., Shaw, R., Pliam, M., Zapolanski, A. J., Murphy, M., Valle, H. V., & Myler, R. (2000). Coronary heart disease in Filipino and Filipino-American patients: Prevalence of risk factors and outcomes of treatment. Journal of Invasive Cardiology, 12(3), 134-139.
4 Angel, A., Armstrong, M. A., & Klatsky, A. L. (1989). Blood pressure among Asian-Americans living in northern California. American Journal of Cardiology, 64(3), 237-340.
5 Grandinetti, A., Chang, H. K., Theriault, A., & Mor, J. (2005). Metabolic syndrome in a multiethnic population in rural Hawaii. Ethnicity & Disease, 5(2), 233-237.
6 Hong, B., & Bayat, N. (1999). National Asian American and Pacific Islander cardiovascular health action plan: Eliminating racial and ethnic disparities in cardiovascular health: Improving the cardiovascular health of Asian American and Pacific Islander populations in the United States. San Francisco, CA: Asian Pacific Islander American Health Forum.
7 Brownstein, J. N., Chowdhury, F. M., Norris, S. L., Horsley, T., Jack, Jr., L., Zhang, X., & Satterfield, D. (2007). Effectiveness of community health workers in the care of people with hypertension. American Journal Preventive Medicine, 32(5), 435-447.
Last Updated: June 2014