Development of a CHW-led intervention for non-western immigrants in the Netherlands with cardiometabolic risk

Abstract

Background: A Community Health Worker (CHW)-led intervention was developed aimed at improving life-style behaviours of non-western immigrants in the Netherlands with a high risk for cardiometabolic disease. Methods: An intervention mapping approach was applied to develop the intervention. This included (1) meta-analyses extracting effective modes of delivery and content of existing CHW-led interventions, (2) qualitative research assessing personal, cultural, and environmental determinants of healthy lifestyles, (3) expert- and target group meetings discussing the intervention content and delivery mode. Program (performance) objectives were matched with behaviour change techniques (BCTs). Results: Findings resulted in a CHW-led intervention consisting of a home visit to explore life- and health goals and to map social support, telephone coaching, and four group sessions that especially focused on skills-related BCTs, such as goal setting, barrier identification, self-monitoring, and mobilizing social support. The content included surface and deep structure strategies to address culture-specific needs. Discussion: Intervention Mapping provided a useful framework to design a culturally sensitive CHW-led intervention for non-western immigrants in the Netherlands.