Cardiovascular Health in Indigenous Communities: Successful Programs

Huffman, Mark D.; Galloway, James M.

doi:10.1016/j.hlc.2010.02.013

Cited by 28 publications

(30 citation statements)

References 39 publications

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“…17 Common traits of successful CVD programs include dedicated focus on the population, widespread community involvement (often through the employment of indigenous CHWs), and regularly scheduled contact between the program and participants. 18 Community health workers are increasingly important as health educators and as bridges between the health care system and underserved communities.…”

Section: Discussionmentioning

confidence: 99%

Healthy Heart, Healthy Family : A NHLBI/HRSA Collaborative Employing Community Health Workers to Improve Heart Health

Fernandes¹,

Braun²,

Spinner³

et al. 2012

hpu

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Kokua Kalihi Valley, a federally qualified health center in Hawaii, collaborated with the National Heart, Lung, and Blood Institute to test the efficacy of community health workers (CHWs) to deliver the Healthy Heart, Healthy Family curriculum to low-income Filipinos with cardiovascular disease (CVD) risk factors. At 12 months, significant improvements were seen in health behaviors, knowledge, and self-efficacy in managing chronic diseases. We also observed decreases in total cholesterol from 186.25 mg/dl to 170.88 mg/dl (p5.001), low-density lipoprotein from 114.43 mg/dl to 103.04 mg/dl (p5.013), and fasting blood glucose from 117.95 mg/dl to 109.07 mg/dl (p5.034). Although these changes were statistically significant, they are small and not clinically meaningful in reducing CVD risk. The high-density lipoprotein was 3.3 mg/dl lower (worse) at 12 months (p5.003), mean values for blood pressure, BMI, and waist circumference increased. Community health workers can be trained to deliver evidence-based curricula that improve health behaviors and increase self-efficacy in managing chronic diseases.

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Section: Discussionmentioning

confidence: 99%

Healthy Heart, Healthy Family : A NHLBI/HRSA Collaborative Employing Community Health Workers to Improve Heart Health

Fernandes¹,

Braun²,

Spinner³

et al. 2012

hpu

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“…The literature also suggests that the ineffectiveness of interventions to modify high risk behaviours in Indigenous populations is likely to be due to a lack of understanding of the wider sets of social meanings attached to those behaviours and of the everyday lives of Indigenous Australians [14,15]. Cardiovascular health and lifestyle programs have also been shown to be more successful and sustainable when they involve Indigenous community members, local knowledge and leadership [16-19]. …”

Section: Introductionmentioning

confidence: 99%

Indigenous perspectives on active living in remote Australia: a qualitative exploration of the socio-cultural link between health, the environment and economics

2013

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BackgroundThe burden of chronic disease in Indigenous Australia is more than double that of non-Indigenous populations and even higher in remote Northern Territory (NT) communities. Sufficient levels of physical activity are known to reduce the risk of chronic disease and improve the health of those already suffering from chronic disease. It has been identified that effective promotion of physical activity in Indigenous settings requires the diverse cultural perspectives and participation of Indigenous people. However, Indigenous concepts of physical activity are not represented in the public health literature and examples of Indigenous involvement in physical activity promotion are scarce. This study aimed to explore and describe local perspectives, experiences and meanings of physical activity in two remote NT Indigenous communities.MethodsQualitative research methods guided by ethnographic and participatory action research principles were used. Semi-structured interviews conducted with 23 purposively selected community members were the main source of data, augmented by five commissioned paintings by community-based artists and observations recorded in a journal by the first author.ResultsThe findings reveal that in this cultural context the meaning of physical activity is embedded in socially significant and economically necessary physical engagement with the environment. Participants described physical activities associated with Indigenous natural and cultural resource management, customary spaces, seasonal timing and traditional education as creating and protecting health. These activities were viewed not only as culturally appropriate physical activities that contribute to health but as legitimate, physically active forms of social organisation, education and employment that help to build and maintain relationships, wealth, resources and the environment.ConclusionThis different construction of physical activity in remote Indigenous communities highlights the importance of involving Indigenous people in the development and implementation of physical activity promotion. Physical activities associated with traditional Indigenous cultural practices and being active ‘on country’ need to be viewed as legitimate health promotion activities. Exploring further ways to enable Indigenous people in remote NT to be involved in creating viable active livelihoods on ‘traditional country’ needs to be considered as imperative to health improvement.

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“…The disparity in life expectancy between Indigenous and non-Indigenous populations in Australia (AU), New Zealand (NZ) and the United States (US) is being driven by heightened incidence of cardio-metabolic non-communicable diseases (ABS, 2006;Huffman and Galloway, 2010;MOH, 2007). Among Indigenous populations, the prevalence of cardiometabolic risk factors, the ability to pursue health lifestyle behaviors, access to health care, and the effectiveness of health promotion strategies have been linked to socio-ecological factors, including educational attainment and economic circumstance (Gibson et al, 2015;Huffman and Galloway, 2010;Katzenellenbogen et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Among Indigenous populations, the prevalence of cardiometabolic risk factors, the ability to pursue health lifestyle behaviors, access to health care, and the effectiveness of health promotion strategies have been linked to socio-ecological factors, including educational attainment and economic circumstance (Gibson et al, 2015;Huffman and Galloway, 2010;Katzenellenbogen et al, 2015). In turn, educational and economic circumstance have historical underpinnings (Cunningham and Stanley, 2003a;King et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Principles and strategies for improving the prevention of cardio-metabolic diseases in indigenous populations: An international Delphi study

Stoner

Matheson

Perry

et al. 2017

Preventive Medicine

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The disparity in life expectancy between Indigenous and non-Indigenous populations is being driven by a heightened incidence of cardio-metabolic diseases, and is at least partly underpinned by educational, economic and historical determinants. However, there is a lack of consensus with regards to priorities for tackling these determinants. Therefore, the current study recruited experts in Indigenous cardio-metabolic health from Australia, New Zealand and the United States, in order to establish local consensus opinion and initiate dialogue. A three-round Delphi process was used to consolidate and compare the opinions of 60 experts, 20 from each country. Round one, the experts were asked three open-ended questions: (i) historical, (ii) economic and (iii) socio-cultural factors contributors to cardio-metabolic disease risk. Round two, the experts completed a structured questionnaire based on results from the first round, in which they ranked items according to their importance. Final round, the experts were asked to re-rank the same items after receiving summary feedback about the rank ordering from the previous round. Several key findings were identified: (i) an important historical factor is marginalization and disempowerment; (ii) in terms of economic and sociocultural factors, the panellists came to the consensus that socio-economic status and educational inequalities are important; (iii) while consensus was not reached, economic and educational factors also perceived to be historically influential. These findings support the need for multi-level health promotion policy. For example, tackling financial barriers that limit access to health-promoting resources, and improving literacy skills to permit understanding of health education.

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Cardiovascular Health in Indigenous Communities: Successful Programs

Cited by 28 publications

References 39 publications

Healthy Heart, Healthy Family : A NHLBI/HRSA Collaborative Employing Community Health Workers to Improve Heart Health

Healthy Heart, Healthy Family : A NHLBI/HRSA Collaborative Employing Community Health Workers to Improve Heart Health

Indigenous perspectives on active living in remote Australia: a qualitative exploration of the socio-cultural link between health, the environment and economics

Principles and strategies for improving the prevention of cardio-metabolic diseases in indigenous populations: An international Delphi study

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