A path analysis of a randomized promotora de salud cardiovascular disease-prevention trial among at-risk hispanic adults

Hendrik de Heer, Hector G. Balcazar, Felipe Castro, Leslie Schulz

Research output: Contribution to journalArticle

14 Scopus citations


This study assessed effectiveness of an educational community intervention taught by promotoras de salud in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of protective health behaviors, health beliefs, contextual and social factors. Participants were 328 Hispanic adults with at least one CVD risk factor. SEM analyses assessed direct and indirect effects of intervention participation on CVD risk (Framingham score) and latent variables nutrition intake and health beliefs. The model fit was adequate (root mean square error of approximation =.056 [90% confidence interval =.040,.072], comparative fit index =.967, normed fit index =.938, nonnormed fit index =.947). Intervention participation was associated with improved nutritional consumption, but not lower CVD risk. Stronger health beliefs predicted healthier nutritional habits. This project provided evidence for the adequacy of a conceptual framework that can be used to elicit new pathways toward CVD risk reduction among at-risk Hispanic populations.

Original languageEnglish (US)
Pages (from-to)77-86
Number of pages10
JournalHealth Education and Behavior
Issue number1
StatePublished - Feb 2012
Externally publishedYes



  • cardiovascular disease
  • community
  • education
  • Hispanic
  • nutrition
  • promotoras de salud
  • structural equation model

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Arts and Humanities (miscellaneous)

Cite this