Lesley Marsha L
College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, MI 48202, USA.
Patient Educ Couns. 2007 Jan;65(1):137-46. doi: 10.1016/j.pec.2006.07.001. Epub 2006 Sep 6.
Hypertension continues to take its toll on millions of African Americans. Adhering to an eating plan called Dietary Approaches to Stop Hypertension (DASH) can significantly lower blood pressure. This study examined whether problem solving training in addition to education on DASH is more effective than education alone to help African Americans in an urban community college setting solve their own dietary problems and change eating behaviors that could affect blood pressure.
A randomized, two groups, multiple post-test design was used. All participants (N=78, 59% female) completed a Problem Solving Instrument immediately post-intervention and a follow-up Telephone Interview 2 weeks later.
Fewer than half had normal blood pressure on screening. The Experimental Group identified and implemented significantly higher quality solutions to the second of their two problems than the Control Group. The intervention effect was the greatest for participants with blood pressure screenings above normal.
Problem solving training combined with nutrition information may help African Americans to deal more effectively with dietary problems especially when the problems are complex or less well-defined.
Dietary interventions that include a focus on everyday problem solving as well as knowledge acquisition can be developed in clinical, community health, school, and worksite settings.
高血压仍在对数百万非裔美国人造成损害。坚持一种名为“终止高血压膳食疗法（DASH）”的饮食计划可显著降低血压。本研究探讨了在DASH教育之外进行问题解决训练，是否比单纯教育更有效地帮助城市社区学院环境中的非裔美国人解决自身饮食问题，并改变可能影响血压的饮食行为。
采用随机、两组、多次后测设计。所有参与者（N = 78，59%为女性）在干预后立即完成一份问题解决量表，并在2周后接受随访电话访谈。
筛查时血压正常的人不到一半。实验组针对其两个问题中的第二个问题，识别并实施了质量显著高于对照组的解决方案。对于血压筛查高于正常水平的参与者，干预效果最为显著。
问题解决训练与营养信息相结合，可能有助于非裔美国人更有效地应对饮食问题，尤其是当问题复杂或定义不明确时。
在临床、社区卫生、学校和工作场所环境中，可以开展包括关注日常问题解决以及知识获取的饮食干预措施。
