A new qualitative study led by researchers from the UC Irvine Joe C. Wen School of Population & Public Health offers critical insights into how Latino families in Orange County, Calif. understand cardiovascular disease and navigate heart healthy decisions.
The findings published in Frontiers Public Health document a culturally tailored, family-based behavioral intervention to reduce cardiovascular disease (CVD), the leading cause of death in the U.S., that evolved in real-time with the impacted community.
The 5-year study, called the Skills-Based Educational strategies for Reduction of Vascular Events in Orange County (SERVE OC), is a clinical trial led by principal investigator Bernadette Boden-Albala, MPH, DrPH, who is the founding dean, a social epidemiologist, and a professor of health, society, and behavior at Wen Public Health and the corresponding author of the paper.
Unlike traditional clinical trials focused on medications or procedures, behavioral clinical trials like SERVE OC test the effectiveness of interventions designed to change health behaviors—such as improving diet, increasing physical activity, and strengthening family-based support. This sub-study used 14 focus groups with nearly 70 participants, comprised of community members, community health professionals, and SERVE-OC trial participants, to explore the social and structural factors that influence cardiovascular health.
Key findings revealed three core themes:
- Gaps in community knowledge, attitudes, and beliefs about cardiovascular disease, including limited understanding of symptoms, risk factors, nutrition, and preventive behaviors. Cultural norms, such as gender dynamics and stigmas around seeking care, also shaped attitudes and behaviors, especially among men.
- Barriers and facilitators to family-based interventions, such as transportation, work constraints, and technology access. Family support, community health workers (CHWs), and culturally inclusive activities emerged as vital enablers.
- Structural and community-level challenges and solutions, including food insecurity, neighborhood safety concerns, and lack of access to preventive services, are major problems. Participants emphasized the need for affordable health education, safe public spaces, and interactive partnerships with local organizations.
Focus groups also uncovered the complex relationship between nutrition and cardiovascular health, with participants describing the difficulties of adopting heart-healthy diets due to traditional cooking practices, food costs, and time limitations.
These insights prompted Boden-Albala and the SERVE OC team to incorporate culturally adapted cooking classes, multigenerational meal planning, and weekend events into its intervention programming.
Importantly, the study validated the role of family networks in supporting long-term behavior change. Participants discussed how relatives help with tasks like meal prep, blood pressure monitoring, and tech support for older adults, highlighting the power of intergenerational engagement in closing health literacy gaps and sustaining healthy routines.
Structural barriers—such as unsafe parks, immigration-related fears, and homelessness in outdoor spaces—were also key concerns. In response, the SERVE OC team is working with a Community Advisory Board and local stakeholders to explore long-term solutions, from improving neighborhood safety to enhancing access to healthcare and nutritious foods.
“Our methods are rooted in the lived experiences of the people we aim to serve,” shares Boden-Albala. “By elevating community voices and addressing both behavioral and systemic challenges, SERVE OC is helping reimagine how public health research and clinical trials can drive real-world impact.”
The study underscores the importance of community-engaged approaches in designing interventions that are not only effective but equitable. Behavioral clinical trials like SERVE-OC are essential for understanding how educational and lifestyle strategies can drive long-term health improvements, especially in communities disproportionately affected by chronic diseases like CVD.