“Social Network Intervention for Cardiovascular Risk Reduction Among Hispanic and Somali Adults: A Cluster Randomized Trial”
Although immigrants and refugees often arrive in the United States with better health than the general population, these advantages diminish over time, in part due to the adoption of unhealthy dietary behaviors. Population-based interventions have had limited success in preserving these early health advantages, highlighting the need for innovative approaches that are tailored to—and led by—immigrant communities themselves. In 2011, RHCP received funding for the Healthy Immigrant Families (HIF) project, in which community and academic partners co-developed a 12-lesson, home-based intervention focused on healthy eating and physical activity, delivered by bilingual interventionists. At 12 months, adults in the intervention group showed significant improvements in dietary quality compared with controls, although improvements were also observed in the control group.
These findings led to the development of the Healthy Immigrant Community (HIC) project, which builds on the HIF model by leveraging social networks to enhance reach, sustainability, and behavior change. The goal of HIC is to adapt the HIF intervention into a social network–based approach to improve dietary behaviors among overweight and obese immigrant adults in Rochester, Minnesota. In February 2020, RHCP launched a pilot study in which Hispanic and Somali adults were trained as Health Promoters through 12 face-to-face lessons taught by Mayo Clinic experts, after which the Health Promoters delivered the same content to social networks of five to ten individuals. Building on this pilot, RHCP enrolled 51 social networks with 475 participants in a randomized clinical trial in June 2022. Health Promoters received real-time training from Health Coaches and led face-to-face or virtual group sessions over 12 months, each focused on key aspects of healthy eating and physical activity. Social networks were randomly assigned to receive the intervention immediately or after a delay of 1 year. Measurements at baseline, 6 months, and 12 months were derived from 6 of the American Heart Association’s “Life’s Simple 7”: body mass index, blood pressure, fasting glucose, cholesterol, physical activity and dietary quality. Compared with the delayed intervention group, participants in the early intervention groups showed a modest improvement of cardiovascular risk and clinically significant weight loss, suggesting that social network interventions hold promise in reducing the rise of obesity and cardiovascular risk accumulation after immigration.
Annals of Behavioral Medicine - May 2026
Immigrants to the United States often face challenges from limited healthcare access and less healthy environments which contribute to rising obesity and cardiovascular risk. Social network interventions, where social networks (for example, friends and family) are used to promote positive behavior change, are a promising approach to improve health outcomes among difficult to reach populations. In this study, a social network intervention was conducted where 51 lay health promoters from Hispanic and Somali immigrant groups delivered a health promotion program to up to 12 members of their social networks for a total of 475 participants. Social networks were randomly assigned to receive the intervention immediately or after a delay of 1 year. Measurements were done at baseline, 6 months, and 12 months, and included measures of cardiovascular risk and weight. Compared with the delayed intervention group, participants in the early intervention groups showed a modest improvement of cardiovascular risk and clinically significant weight loss, suggesting that social network interventions hold promise in reducing the rise of obesity and cardiovascular risk accumulation after immigration.