Corazon en tus Manos: A Culturally-Tailored Stress-Reduction Intervention to Reduce Cardiovascular Disease Risk among Mexican-origin Adults with Confirmed NAFLD
openNHLBI - National Heart Lung and Blood Institute
ABSTRACT
Cardiovascular disease (CVD), the leading cause of death in the U.S., impacts 42.7% of Hispanic women and
52.3% of Hispanic men. Metabolic dysfunction-associated steatotic liver disease (MASLD), a risk factor for
hepatocellular carcinoma, is a well-known risk factor for CVD. Several studies have shown that MASLD is
associated with a 64% increased risk of CVD. Conversely, CVD is the leading cause of death among individuals
with MASLD. Chronic psychological stress has been posited as one of potential pathways linking MASLD to
CVD. The impact of chronic social stressors on CVD has been shown to be comparable to behavioral risk factors;
however, CVD risk reduction interventions have rarely incorporated stress-management techniques and none
that we know of have been contextually tailored for Hispanics with MASLD. This is a significant oversight given
that estimates indicate that the overall prevalence of MASLD among Mexican-origin (MO) adults in Southern
Arizona is 50%, higher even than the 43% prevalence reported nationally. Dr. Adriana Maldonado has committed
her career to conducting research that identified and addresses the root causes of health inequities faced by
Hispanic populations. Her long-term career goal is to become a leading CVD health disparities investigator.
Thus, the overall objective of this K01 application is to examine the acceptability and feasibility of an adapted
version of “Su Corazón, Su Vida”, a community-health worker-led evidence-based curriculum, which includes
stress-management techniques. Su Corazon, Su Vida was designed to increase CVD risk awareness and
promote healthy food choices and physical activity among the U.S. Hispanic population. To ensure the
successful completion of study aims, Dr. Maldonado has designed a training plan that complements her current
skills and builds on the following domains: 1) pathophysiology of CVD and stress-related biomarkers, 2)
adaptation, implementation, and dissemination of contextually-centered behavioral interventions, and 3) clinical
trial design. The training plan takes full advantage of the rich training environment for Hispanics at the University
of Arizona and is supported by senior faculty mentors. For the proposed project, Dr. Maldonado aims to (1)
investigate the relationship between acculturative stress, pro-inflammatory biomarkers, and CVD risk in MO
adults with confirmed MASLD in the Arizona U.S./Mexico border region; (2) adapt “Su Corazón, Su Vida” to
include stress-management techniques to decrease CVD risk among MO adults with confirmed MASLD in the
Arizona U.S./Mexico border region; and (3) pilot test “Corazón en tus Manos”, the adapted version of “Su
Corazón, Su Vida”, among MO adults with confirmed MASLD in the Arizona U.S./Mexico border region. This
K01 award paired with career objective training aims and mentoring from an outstanding multidisciplinary team
of mentors, will catalyze Dr. Maldonado’s transition to an independent career focused on the design,
implementation, and evaluation of contextually-centered multilevel interventions to reduce the burden of CVD in
Hispanic communities along the U.S./Mexico border region.
Up to $140K
health research