Interventions

Health Promotion and Disease Prevention

See recommendations for preventive care for all older Americans in Module Five of the Core Curriculum in Ethnogeriatrics. Special issues for Hispanic/Latino elders include the following:

1. Preventive Screening
   1. Cervical Cancer Because of the very high incidence of cervical cancer among Hispanic/Latino women, special attention to appropriate screening is recommended.
   2. Diabetes Periodic blood glucose monitoring for Puerto Rican and Mexican American elders is recommended because of the high incidence of diabetes, much of which is undiagnosed.
   3. Depression Appropriate assessment of depression is important, especially among less acculturated older women.
   4. Falls and Hip Fracture Some studies have found increased risk among Mexican American elders, so special attention is recommended (Espino, Palmer, Miles, et al., 2000; Mouton, Smith, Jarosek et al., 2000).
2. Health Education
   1. Grassroots outreach educational programs for health promotion can benefit older Hispanic/Latinos. One study showed benefits to the use of a community health worker to conduct diabetes education; it improved knowledge levels, self-care management, and lowered glycohemoglobin levels from 11.7% to 9.9% (Corkery, Palmer, Foley, et al., 1997).
   2. Important considerations for health promotion materials are that they should target appropriate reading levels and should have undergone the rigorous translation/back translation methods and pilot testing procedures prior to dissemination (Talamantes, Gomez, Braun, 2000). (See Section IV). Caution should be taken about solely relying on written materials/brochures for health promotion purposes even when translated into Spanish.
   3. When relying on telephone methods, health providers or outreach workers miss the population of Hispanic/Latino elders that do not have a telephone. Media (television and radio) has been previously reported to be an effective method for outreach (Anson, 1988; Mosca, Jones, King, et al., 2000). More Hispanic women than other ethnic groups reported to have learned about heart disease through a friend or family member (Mosca et al., 2000).
3. Physical Activity and Exercise
   According to the Behavioral Risk Factor Surveillance System Report (BRFSS, 1997) from Texas, 65% of Hispanic adults do not participate in regular physical activity. Data are not available for elderly Hispanics, however in a study on older Mexican American women and physical activity, researchers found a high correlation between exercise self-efficacy (confidence in the ability to persist with exercising in various situations) and the stage of readiness for exercise (Laffrey, 2000). With advancing age older Mexican American women decreased both their daily and leisure/sport activities.