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Given the growing epidemics of chronic diseases in developing countries, we launched an intervention to reduce cardiovascular risk in adult men and women diagnosed with hypertension and/or type 2 diabetes mellitus, in Chiapas and Costa Rica.Intervention (INT) consists of 6 educations sessions to promote healthy life styles, offered by primary health care workers on a monthly schedule. INT is compared with standard care (SC) following a quasi‐experimental design. All participants are followed up at the clinic for 8‐months.We have 95 INT participants and 90 SC participants in Chiapas, and 84 INT and 86 SC in Costa Rica. Almost 80% of all participants are overweight or obese in both countries. The INT group in Costa Rica presents 50% co‐morbidity of hypertension and diabetes, and 9% co‐morbidity in Chiapas. INT participants present systolic blood pressure of 134 ± 23 mmHg in Chiapas and 140 ±20 mmHg in Cost Rica; and fasting glucose levels of 144.2 ± 66.5 mg/dl in Chiapas and 119.0 ± 48.4 mg/dl in Costa Rica. Over 90% of participants report taking medication. Baseline CVD risk is lower in both groups from Chiapas compared to INT and SC groups in Costa Rica.Most INT participants in both countries present uncontrolled metabolic risk factors, offering an opportunity for the intervention to demonstrate a beneficial effect as compared to those receiving standard care. Challenges include limited attendance to education sessions.

ObjectiveTo understand why patients have difficulty managing chronic diseases, we studied the perceptions of type 2 diabetic/hypertensive (DM2/HTN) patients and health personnel regarding services offered at primary healthcare (PHC) centers.MethodsFocus group discussions were conducted with patients (10 groups, total n=76) and PHC staff (4 groups, total n=25) from 4 urban communities (San José=2; Chiapas=2). We focused on: perceived knowledge and attitudes about disease, self‐care practices, PHC quality, and communication issues.ResultsPatients affirmed that having DM2 and HTN is a physical, financial and emotional burden both to them and their families. Family members were not perceived as supportive, resulting in feelings of isolation. Genetics was considered the main risk factor for DM2, above modifiable lifestyle factors. Most patients stated not knowing how to manage their DM2/HTN. Patients and staff lacked nutritional education; however, they acknowledged the role of nutrition in disease management. PHC staff should encourage more proactive self‐care skills but did not feel prepared to deal with patients’ attitudinal and know‐how issues.ConclusionsThese results will be used to tailor an intervention to strengthen patient‐staff communication, facilitate a bi‐directional learning process, and empower patients to take control of their health.Funding: NHLBI‐HHSN 268200900028C