IntroductionHispanics in the United States have disproportionately high rates of obesity, hypertension, and diabetes and poorer access to preventive health services. Healthy Fit uses community health workers to extend public health department infrastructure and address Hispanic health disparities related to cardiovascular disease and access to preventive health services. We evaluated the effectiveness of Healthy Fit in 1) reaching Hispanic Americans facing health disparities, and 2) helping participants access preventive health services and make behavior changes to improve heart health.MethodsCommunity health workers recruited a sample of predominantly low-income Hispanic immigrant participants (N = 514). Following a health screening, participants received vouchers for breast, cervical, and colorectal cancer screening, and received vaccinations as needed for influenza, pneumonia, and human papillomavirus. Participants who were overweight or had high blood pressure received heart health fotonovelas and referrals to community-based exercise activities. Community health workers completed follow-up phone calls at 1, 3, and 6 months after the health screening to track participant uptake on the referrals and encourage follow-through.ResultsParticipants faced health disparities related to obesity and screening for breast, cervical, and colorectal cancer. Postintervention completion rates for breast, cervical, and colorectal cancer screening were 54%, 43%, and 32%, respectively, among participants who received a voucher and follow-up phone call. Among participants with follow-up data who were overweight or had high blood pressure, 70% read the fotonovela, 66% completed 1 or more heart health activities in the fotonovela, 21% attended 1 or more community-based exercise activities, and 79% took up some other exercise on their own.ConclusionHealthy Fit is a feasible and low-cost strategy for addressing Hispanic health disparities related to cancer and cardiovascular disease.

Background Hispanic immigrants continue to experience higher rates of overweight and obesity compared to their non-Hispanic counterparts. Acculturation may contribute to unhealthy weight gain among immigrant populations by shifting dietary patterns from high fruit and vegetable consumption to unhealthier high fat diets. Healthy Fit, a culturally tailored community health worker (CHW) intervention, aims to reduce obesity related outcomes by providing physical activity and nutrition education and resources in a low-income Hispanic population. This study aims to evaluate outcomes of Healthy Fit participants and examine changes in body composition in relation to level of acculturation at baseline and follow-up. Method In this longitudinal observational study, CHWs recruited 514 participants from community events and agencies serving low-income Hispanic populations in El Paso, Texas from 2015 to 2016. Following an in-person health screening, eligible participants received nutrition and physical activity education guided by fotonovelas, comic-like educational books. Telephone follow-ups made at 1, 3, and 6 months by CHWs encouraged follow-through on referrals. 288 participants completed the screening again during the 12-month follow-up. Results The sample was predominantly Hispanic (96%), female (82%), uninsured (79%), had a household income of less than $19,999 (70%), foreign-born (79%), preferred Spanish (86%) and few rated themselves as good or excellent for English proficiency (27%). Overall, Healthy Fit participants significantly improved (i.e., decreased) BFP by 0.71% (t = 2.47, p = 0.01) but not BMI (b = .01, t = − 0.14, p = .89). Contrary to expectations, acculturation was not associated with lower BMI (b = 0.09, p = 0.84) or BFP (b = 0.13, p = 0.85) at baseline. However, acculturation predicted changes in both BMI (b = 0.30, p = 0.03) and BFP (b = 1.33, p = 0 .01) from baseline to follow-up. Specifically, the low acculturation group improved in body composition measures over time and the high acculturation group did not improve in either measure. Conclusion Findings suggest Healthy Fit was most effective among less acculturated individuals. The influence of acculturation on the efficacy of nutrition and exercise interventions suggests that Hispanics should not be treated as a homogenous subgroup.

Youth maintain several tensions in their views on tobacco. Tobacco use is considered unpleasant and harmful, yet youth perceive their peers to view it as cool. Peer to peer discussion of tobacco experiences and perceptions may help correct these incongruent viewpoints. Adding to this tension is the perception that tobacco is used to manage stress. Given the importance of the home environment for Hispanic youth, tobacco prevention efforts may benefit from engaging family to identify the ways in which tobacco use causes stress.

Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.