Bedford Veterans Affairs Medical Center, Massachusetts, USA.
Ann Intern Med. 2011 Jan 18;154(2):77-84. doi: 10.7326/0003-4819-154-2-201101180-00004.
Storytelling is emerging as a powerful tool for health promotion in vulnerable populations. However, these interventions remain largely untested in rigorous studies.
To test an interactive storytelling intervention involving DVDs.
Randomized, controlled trial in which comparison patients received an attention control DVD. Separate random assignments were performed for patients with controlled or uncontrolled hypertension. (ClinicalTrials.gov registration number: NCT00875225)
An inner-city safety-net clinic in the southern United States.
230 African Americans with hypertension.
3 DVDs that contained patient stories. Storytellers were drawn from the patient population.
The outcomes were differential change in blood pressure for patients in the intervention versus the comparison group at baseline, 3 months, and 6 to 9 months.
299 African American patients were randomly assigned between December 2007 and May 2008 and 76.9% were retained throughout the study. Most patients (71.4%) were women, and the mean age was 53.7 years. Baseline mean systolic and diastolic pressures were similar in both groups. Among patients with baseline uncontrolled hypertension, reduction favored the intervention group at 3 months for both systolic (11.21 mm Hg [95% CI, 2.51 to 19.9 mm Hg]; P = 0.012) and diastolic (6.43 mm Hg [CI, 1.49 to 11.45 mm Hg]; P = 0.012) blood pressures. Patients with baseline controlled hypertension did not significantly differ over time between study groups. Blood pressure subsequently increased for both groups, but between-group differences remained relatively constant.
This was a single-site study with 23% loss to follow-up and only 6 months of follow-up.
The storytelling intervention produced substantial and significant improvements in blood pressure for patients with baseline uncontrolled hypertension.
Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation.
讲故事作为一种在弱势群体中促进健康的有力工具正在兴起。然而，这些干预措施在严格的研究中仍然在很大程度上未经测试。
测试一种涉及 DVD 的互动式讲故事干预措施。
一项随机对照试验，其中比较组患者接受了注意力控制 DVD。为控制或未控制高血压的患者分别进行了单独的随机分组。（临床试验.gov 注册号：NCT00875225）
美国南部一个城市内的医疗保障诊所。
230 名高血压的非裔美国人。
3 张包含患者故事的 DVD。故事讲述者来自患者群体。
干预组与对照组在基线、3 个月和 6 至 9 个月时的血压差异变化是结果。
2007 年 12 月至 2008 年 5 月期间随机分配了 299 名非裔美国患者，76.9%的患者在整个研究过程中保留下来。大多数患者（71.4%）为女性，平均年龄为 53.7 岁。两组患者的基线平均收缩压和舒张压相似。在基线未控制高血压的患者中，干预组在 3 个月时收缩压（11.21mmHg[95%CI，2.51 至 19.9mmHg]；P=0.012）和舒张压（6.43mmHg[CI，1.49 至 11.45mmHg]；P=0.012）的降幅均更有利。基线控制良好的高血压患者在研究组之间随时间无显著差异。两组的血压随后均升高，但组间差异相对稳定。
这是一项单站点研究，随访率为 23%，随访时间仅为 6 个月。
对于基线未控制高血压的患者，讲故事干预措施可显著改善血压。
寻找答案：罗伯特伍德约翰逊基金会的一个全国性项目，用于解决差异研究。
