Healthy immigrant community study protocol: A randomized controlled trial of a social network intervention for cardiovascular risk reduction among Hispanic and Somali adults
By many health measures, immigrants arrive in the United States (US) healthier than the general US population. [1] However, the longer immigrants reside in the US, the more they approximate the high health risk profiles of the general population for cardiovascular disease and related chronic conditions. [2,3] Approximately 15 years after immigration, the prevalence of obesity among immigrants to the US approximates that of US-born adults. [4] Among immigrant populations to high-income nations, dietary and physical activity behaviors are less healthy than the non-immigrant majority populations. [5,6]
Evidence-based health promotion programs in group settings have been shown to be effective at improving health behaviors in general populations, [7] but despite calls for interventions to address obesity and health behaviors among immigrant populations, [8] few intervention studies have been reported. [9]
One novel approach is to utilize social networks to promote a healthy lifestyle. A range of social network characteristics are highly associated with obesity-related health behaviors in the general populations (nutritional intake and physical activity). [10] These findings apply to obesity; for example, a 32-year longitudinal study showed a person’s chances of becoming obese increased by 57% if their network partners (friends, family, neighbors, etc) became obese, which was mediated by the frequency and intensity of interactions. [11]
While a causal link between social network factors and obesity cannot be demonstrated by a single study, a body of evidence has emerged that supports the contribution of social network constructs to the obesity epidemic and cardiovascular risk accumulation in the US. [12–15]