Feasibility of a culturally adapted positive psychological intervention for Hispanics/Latinos with elevated risk for cardiovascular disease

Abstract

Although increasing emotional well-being has been proposed as a potential pathway to drive cardiac health, emotional well-being interventions for people with cardiac risk are underdeveloped, particularly among Hispanic/Latino adults. Our objective was to pilot a well-being intervention drawing on positive psychology concepts to determine feasibility and acceptability in Hispanics/Latinos at risk for cardiovascular disease (CVD). We developed a Spanish-language positive psychological intervention, with cultural tailoring informed by formative qualitative work, to promote emotional well-being and its antecedents in Hispanics/Latinos. Hispanic/Latino adults (n = 19) self-reporting two or more CVD risk factors were enrolled in our single-arm 8-week pilot trial. The group intervention consisted of 8 weekly 90-min sessions delivered by a bilingual licensed clinical social worker. Mean age was 54.1 years, 68.8% were female, and 50% had ≤eighth-grade education. Eleven of 19 Hispanic/Latino adults completed the 8-week program for a 57.89% retention rate, with a majority of factors leading to dropout unrelated to program content or mode of delivery. Most participants felt satisfied overall with each session (97.1%). Largest increases relative to baseline after receiving the intervention were found in engagement in happiness-inducing behaviors (e.g., meditation), emotional vitality, and subjective happiness using metrics of reliable change and effect sizes. This single-arm trial documented adequate feasibility and acceptability, although strategies to increase retention are warranted. Future studies should test our intervention using a randomized trial design with a larger sample size and inclusion of biomarkers (e.g., C-reactive protein) to document impact of our intervention on cardiac-related health.

“iAlegrate!”—A culturally adapted positive psychological intervention for Hispanics/Latinos with hypertension: Rationale, design, and methods

“…We then tested our newly designed curriculum using a non-experimental design. Specifically, pilot testing of our “¡ Alegrate !” intervention using a single group pre-post design evidenced robust feasibility and facilitated derivation of strategies to enhance tailoring and increase overall retention [ 12 ]. Specifically, 11 of 19 Hispanic/Latino adults completed the 8-week pilot for a 57.89% retention rate, with a majority of factors that led to drop out unrelated to program content or mode of delivery.…”

“…Similar methods will be employed to that used when initially piloting our “ iAlegrate! ” trial for feasibility using a pre-experimental design, as previously published [ 12 ].

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“…Similar data collection methods and survey tools were used when piloting our “ iAlegrate! ” intervention for feasibility using a pre-experimental design [ 12 ].…”

A Web-Based Positive Psychological Intervention to Improve Blood Pressure Control in Spanish-Speaking Hispanic/Latino Adults With Uncontrolled Hypertension: Protocol and Design for the ¡Alégrate! Randomized Controlled Trial

“…Briefly, 8 empirically validated behavioral and cognitive skills are taught via our web-based interface, and include the following: (1) identification and use of personal strengths; (2) noticing of positive events in daily life; (3) prolonged appreciation and relishing of positive events; (4) positive reappraisal of stressful events or situations; (5) gratitude; (6) regular practice of mindfulness and meditation; (7) setting and working toward pragmatic and achievable goals; and (8) planning and performing acts of kindness. We previously tested the in-person delivery of MARIGOLD in the Spanish language [ 19 ].…”

“…Additional research is needed, however, to explore strategies that boost psychological well-being specifically in Hispanic/Latino adults and whether this leads to better heart health and BP management. To date, pilot trials highlight that Hispanic/Latino adults find interventions targeting psychological well-being both enjoyable and beneficial [ 19 , 20 ].…”