Assessment of Cardiovascular Disease Occupational Risk Factors of Tampa Latino Populations

1. Assessment of Cardiovascular Disease Occupational Risk Factors of Tampa Latino Populations Jonathan Meadows University of South Florida April, 15 2007 NCUR 21st Conference San Raul, California

2. Overview • Problem • Purpose • Target Population • Visual Representation • Methodology • Data Collection

3. Problem: Introduction • US: • Cardiovascular Disease (CVD): #1 cause • One out of five adults: some level of CVD • Florida: • Heart Disease #1 (48,129 deaths) • Stroke #3 • Hillsborough County • 2,417 out of 48,129 death via Heart Disease

4. Problem: Introduction • Hispanic Population • Fastest growing population segment • Cultural assimilation increase CVD incidences • CVD causes ¼ of deaths • Longer length of residence in US increase CVD risk

5. Problem: Literature Review • CVD Statistical Targets • Minor systolic blood pressure reduction • Cholesterol reduction • Significantly uncontrolled in CVD affected populations • High Cholesterol • High Blood Pressure

6. Problem: Literature Review • Five Common Risk Factors: • High blood pressure • High cholesterol • Atherosclerosis • Cigarette smoking • Diabetes • Familial history • Deficit in awareness in the general Latino community regarding: • Impact on lifestyle on CVD • Behavior on CVD • Need for behavior change

7. Problem: Literature Review • Occupational Health Hazards • High-level stress jobs • Injury and illness rate increased more than non-Latinos • Extreme high temperature • Environmental tobacco smoke • Labor Intensive occupations with little reward • Documented increase in carotid atherosclerosis

8. Purpose • To determine the impact of occupational health hazards on the rates of CVD in Latinos • To identify significant physiological and occupational risk factors among Latinos to be used as CVD intervention targets • To increase awareness of risk factors associated with CVD in the Latino population

9. Target Population • Latinos: • Language & cultural barriers • Difference in distribution resources • Rural Hillsborough County • Metro Tampa • 100 participants • Data selection: • Inclusionary principles: Latinos living in Tampa-Metro Area • No-cost clinical treatment & referral system for Latino population 150% under federal poverty guidelines

10. Methodology Outline • Assessment of CVD risk factors • Assessment of Occupational health hazards • Dissemination of educational material • Implement high risk individual counseling, referrals to group health education, occupational safety training

11. Visual Representation Self- Referral Physician Referral High Risk CVD Hispanic Clientt Client contact via outreach or seek information Client CVD High-Risk Diagnosed CVD Assessment of CVD & Occupational Haz Risk Tracked for follow-up (upon request) N Asses interest in participation 1-on-1 Counseling Y Assessment of CVD & Occupational Haz Risk. Contact/ Visited & Tracked for follow (upon request) Enters Ama tu Corazón (Ama) N Physician referral Y Y High risk is determined Attendance of Ama and counseling PRN Addition to database; Followed-up for evaluation Future program development(1) N Physician Monitors Client Referral to Ama for Health education & Prevention

12. Methodology: Theoretical Framework • Ecological Perspective • Assessment of CVD Risk Factors & Occupational Hazards • Transtheoretical Perspective • Promote healthy lifestyle, behavior change, & occupational safety • Social Marketing Perspective • Techniques of commercial marketing to influence behavior

13. Methodology: Data Collection • Collection of baseline data • Tool: Job Content Questionnaire (JCQ) • Function: Asses risk to predicted job-related illness • 1-4 Likert Scale • Scales for Occupation Assessment: • Job decision latitude • Workplace social support • Work related physical exertion

14. Methodology: Data Collection • Additional CVD Survey Components • Demographic data • Health indicators • Health behaviors • Clinical • Blood Pressure • Weight • Waist circumference • Instrument administration • Face-to-face (Health educator)

15. Methodology: Dissemination • Increase general awareness • Health educators • Assigned to free clinic serving Latino population • Distribute materials & promote educational discussion • Entry into self-referral path of study • Study Recruitment • Occupational safety classes recruitment • Usage of various American Heath Association

16. Methodology: Implementation • Adherence to specialized health education classes • Ama Tu Corazón classes with occupational health hazard component • Usage of ecological approach • Prevention targets: • Physical environment • Availability of services • Usage socio-cultural approach: • Providing culturally appropriate interventions

17. Methodology: Implementation • Program: Integration into NHLBI’s “Su Corazón, Su Vida” • Behavioral change mobility via skill building activities • Start of class • If high risk: referral to “physician pathway” • If not: continuation • All clients are given record to document BP & Weight for 2-3 months • Nine-lesson program • Mobility thought stages of behavior • Lessons & Session: Review, education, pledges, culturally sensitive retention activities

18. Data Analysis • Data Sources • JCQ survey • Demographics • Independent Variables: • Sex, age, physical activity, smoking, occupation type, job stress, job strain • Dependent Variable: Blood pressure • Microsoft Access database

19. Data Analysis • Statistics • SPSS Software • Univariate analyses • Bivariate analyses • Analysis of Covariance (ANCOVA): analysis of proposed research questions

20. Acknowledgements • Collaborative effort • Jaime Corvin, PhD, MSPH • Primary investigator • Assistant Professor, USF College of Public Health • Secretary and Treasure, Fundación Familia Sana • Wayne Westhoff, PhD, MPH, MSW • Assistant Professor, USF College of Public Health • President, Fundación Familia Sana • Staff and Faculty of USF Office of Undergraduate Research • University of South Florida • Dominican University of California • NCUR

21. Fine Questions & Answers Meadows 2007