Corazon en tus Manos: A Culturally-Tailored Stress-Reduction Intervention to Reduce Cardiovascular Disease Risk among Mexican-origin Adults with Confirmed NAFLD - 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.
