Language


Language of Health was part of a federally funded initiative to develop heart disease prevention interventions for low-literate populations. Language for Health specifically intervened with recent immigrants enrolled in English-as-a-Second-Language (ESL) classes, incorporating nutritional behavior change into English language curricula. Latino participants (n=732) were exposed to either nutrition education or stress management classes (attention-placebo group) designed specifically for low English-literate adults. Participants completed physiological measures assessing blood pressure, total and high-density lipoprotein (HDL) cholesterol, waist and hip circumference, and weight. Self-report surveys were administered to collect students nutrition-related knowledge, attitudes, self-reported fat avoidance behaviors, and demographic information. Data were collected at baseline, 3-month post-test and 6-month follow-up. Results indicated long-term effects of the intervention on nutrition knowledge and fat avoidance, yet only short-term effects on total cholesterol: HDL ratio and systolic blood pressure.

Principal Investigator:	John P. Elder, Ph.D., MPH
Co-Principal Investigators:	Susan I. Woodruff, Ph.D. and James Sallis, Ph.D.
Dates:	July 1 1992 to Feb. 28 1997
Total Funding:	Direct $l.6 Million; Total $2.5 Million
Funding Source:	The National Heart, Lung and Blood Institute
Major Findings:
Language for Health Complete Bibliography Journal Articles and Book Chapters published or in press Alvarado, O. (1996). Process Evaluation of a Nutrition Based Program for Low-English Proficient Latinos in English-as-a-Second-Language (ESL) Classes. The Health Education Monograph Series,14(2), 17-21. Apodaca, J.X., Woodruff, S.I., Candelaria, J.I., Elder, J.P., & Zlot, A. (1997). Hispanic health program participant and non-participant characteristics. American Journal of Health Behavior, 21(5), 356-363. Candelaria, J.I., Campbell, N., Lyons, G., Elder, J.P., & Villaseor, A. (1998) Strategies for health education: Community based methods. In S. Loue (ed): Handbook of Immigrant Health. New York: Plenum. Candelaria, J., Woodruff, S.I., & Elder, J.P. (1996). Language for Health: Nutrition Education Curriculum for Low-English Literate Adults. Journal of Nutrition Education, 28(5), Gem No. 266, 293C. Creech, L., Woodruff, S.I., Lopez, Y., Candelaria, J.I., & Elder, J.P. (1997). Obesity and Cardiovascular Risk Factors in Latinos Attending English as a Second Language Class. Manuscript submitted for publication. Elder, J.P., Candelaria, J., Woodruff, S.I., Criqui, M.H., Talavera, G.A., & Rupp, J.W. (2000). Results of Language for Health: Cardiovascular Disease Nutrition Education for Latino English-as-a-Second-Language Students. Health Education and Behavior 27(1), 50-63. Elder, J.P., Candelaria, J., Woodruff, S.I., Golbeck, A.L., Criqui, M.H., Talavera, G.A., Rupp, J.W., & Domier, C.P. (1998). Initial Results of "Language for Health": Cardiovascular Disease Nutrition Education for Latino English-as-a-Second-Language Students. Health Education Research, 13(4), 567-575. Elder, J.P., Parra-Medina, D., Zuiga de Nuncio, M.L., & Apodaca, J.X. (1998). Theoretical models of health education. In S. Loue (ed): Handbook of Immigrant Health. New York: Plenum. Elder JP, Woodruff SI, Candelaria J, Golbeck AL, Alvarez JL, Criqui MH, Norquist CD, & Rupp JW. (1998). Socioeconomic indicators related to cardiovascular disease risk factors in Hispanics. American Journal of Health Behavior, 22(3), 172-185. Frack, S.A., Woodruff, S.I., Candelaria, J. & Elder, J.P., (1997). Correlates of Compliance with Measurement Protocols in a Latino Nutrition Intervention Study. American Journal of Preventive Medicine, 13(2), 131-136. Lyons, G.K., Woodruff, S.I., Candelaria, J.I., Rupp, J.W., & Elder, J.P. (1997). Effect of a Nutrition Intervention on Macronutrient Intake in a Low English-Proficient Hispanic Sample. American Journal of Health Promotion, 11(5), 371-374. Lyons, G.K., Woodruff, S.I., Candelaria, J., Rupp, J., & Elder, J.P. (1996). Development of a Protocol to Assess Dietary Intake Among Hispanics who have low literacy skills in English. Journal of the American Dietetic Association, 96(12), 1276-1279. Norquist, C.D., Woodruff, S.I., Candelaria, J., & Elder, J.P. (1997). Cardiovascular risk factors among adult Latinos enrolled In English language classes: A comparative study. Journal of Border Health, II(1), 10-15. Woodruff, S.I., Candelaria, J., Elder, J.P., Gichon, E.A., & Zaslow, K.A. (1996). Implementation Factors Related to Outcomes of a Nutrition Education Program for Latinos with limited English proficiency. Journal of Nutrition Education, 28(4), 219-222. Woodruff, S.I., Zaslow, K.A., Candelaria, J., & Elder, J.P. (1997). Effects of Gender and Acculturation on Nutrition-related Factors among limited-English proficient Hispanic adults. Ethnicity And Disease, 7, 121-126 Woodruff SI. (1997). Random-effects models for analyzing clustered data from a nutrition education intervention. Evaluation Review, 21(6), 688-697. Presentations at Scientific and Professional Conferences Apodaca, J.X., Elder, J., Candelaria, J., Woodruff, S., & Zlot, A. (1995, November). Characteristics of voluntary and non-participants of a health related behavior modification program. Poster session presented at the 123rd Annual Meeting of the American Public Health Association, San Diego, California. Barnes, A., Elder, J., Woodruff, S., Lyons, G., & Alvarez, J. (1995, November). The effects of nutrition knowledge and self-efficacy on changes in eating behaviors. Presented at the 123rd Annual Meeting of the American Public Health Association, San Diego, California. Candelaria, J. (1994, February). Caring for your heart. Presented at 10th Biennial National Conference on Hispanic Health and Human Services (COSSMHO), Washington, DC. Candelaria, J.I. (1998, February). "Language for Health": Cardiovascular Disease Nutrition Education for Latino English-as-a-Second-Language Students. Presented at Cardiovascular Health: Coming Together for the 21st Century, National Conference, San Francisco, California. Candelaria, J., Elder, J., Woodruff, S., Alvarez, J., & Lyons, G. (1995, November). One-year results of a nutrition education program for a low literate, Spanish-speaking population. Presented at the 123rd Annual Meeting of the American Public Health Association, San Diego, California. Candelaria, J., Elder, J., Woodruff, S., Lyons, G., Criqui, M., Golbeck, A., Talavera, G., Rupp, J. (1996, November). Overall Results of a Nutrition Education Program for a Limited-English Proficient Hispanic Population. Poster session presented at the 124th Annual Meeting of the American Public Health Association, New York, NY, Candelaria, J., Medel, Y., Alvarez, J., Lyons, G., Elder, J., Talavera, G., Criqui, M., Rupp, J., & Golbeck, A. (1993, October). Nutrition education for a low literate Latino population. Presented at the 122nd Annual Meeting of the American Public Health Association, Washington, DC. Creech, L., Woodruff, S.I., Lopez, Y., Candelaria, J.I., & Elder, J.P. (1996, November). Obesity and CVD Risk Factors in Latinos: Which Obesity Measure is a Better Predictor of Risk. Poster session presented at the 124th Annual Meeting of the American Public Health Association, New York, NY. Elder, J., Candelaria, J., Alvarez, J., Lyons, G., Talavera, G., Criqui, M., Rupp, J., & Golbeck, A. (1994, October). Correlation between literacy level and health outcomes from a CVD nutrition education program for low literate Spanish-speaking ESL students. Presented at the 122nd Annual Meeting of the American Public Health Association, Washington, DC. Elder, J., Candelaria, J., Alvarez, J., Lyons, G., Talavera, G., Criqui, M., Rupp, J., & Golbeck, A. (1994, October). Preliminary results of a nutrition education program for a low literate, Spanish-speaking population. Presented at the 122nd Annual Meeting of the American Public Health Association, Washington, DC. Elder, J., Candelaria, J., Alvarez, J., Medel, Y., Lyons, G., Talavera, G., Criqui, M., Rupp, J., & Golbeck, A. (1993, October). Development of a Spanish language literacy assessment tool for a CVD nutrition education program for ESL students. Presented at the 122nd Annual Meeting of the American Public Health Association, Washington, DC. Elder, J., Candelaria, J., Woodruff, S., & Alvarez, J. (1995, March). Integrating nutrition education into community college English as a second language classes. Poster session presented at the 16th Annual Meeting of the Society of Behavioral Medicine, San Diego, California. Elder, J., Candelaria, J., Woodruff, S., & Alvarez, J. (1995, May). Results of a heart health nutrition education program for a low English-literate, Spanish-speaking population. Poster session presented at the 2nd International Heart Health Conference, Barcelona, Spain. Elder, J., Lamb, J., Candelaria, J., Alvarez, J., Lyons, G., Talavera, G., Criqui, M., Rupp, J., & Golbeck, A. (1994, October). Effect of a nutrition education program on saturated fat/cholesterol avoidance behavior and plasma cholesterol levels in adult English as a second language students. Presented at the 122nd Annual Meeting of the American Public Health Association, Washington, DC. Elder, J., Lyons, G., Candelaria, J., Rupp, J., Alvarez, J., Talavera, G., Criqui, M., & Golbeck, A. (1994, October). Use of a standardized nutrition computer program for 24 hour dietary recalls with a low literate Latino population. Presented at the 122nd Annual Meeting of the American Public Health Association, Washington, DC. Lyons, G., Creech, L., Candelaria, J., Elder, J., Rupp, J., Alvarez, J., & Woodruff, S. (1995, November). Use of a computerized nutrient analysis program to measure dietary intake in an intervention program targeting low literacy Latinos. Poster session presented at the 123rd Annual Meeting of the American Public Health Association, San Diego, California. Lyons, G.K., Elder, J.P., Campbell, N., & Woodruff, S.I. (1995, March). Trends in healthy eating habits of Hispanics in San Ysidro, California. Poster session presented at the 16th Annual Meeting of the Society of Behavioral Medicine, San Diego, California. Lyons, G., Woodruff, S.I., Candelaria, J., Rupp J., Elder, J.P. (1996, November). Long-term Effects of Nutrient Intake of an Intervention Program Targeting Limited-English Proficient Latinos. Poster session presented at the 124th Annual Meeting of the American Public Health Association, New York, NY. Woodruff, S.I. (May, 1996). Random effects models for analyzing clustered data: examples from a nutrition education intervention. Poster session presented at the 1996 San Diego Biostatistics and Epidemiology Exchange, San Diego, California. Woodruff, S.I., Elder, J.P., Candelaria, J., & Alvarez, J. (1995, March). Sociodemographic status and cardiovascular disease risk factors in a limited English-proficient Hispanic sample. Poster session presented at the 16th Annual Meeting of the Society of Behavioral Medicine, San Diego, California. Woodruff, S.I., Elder, J.P., Candelaria, J., Alvarez, J., & Gichon, E. (1995, November). Implementation factors related to outcomes of an Hispanic nutrition education program. Poster session presented at the 123rd Annual Meeting of the American Public Health Association, San Diego, California.