J Acad Nutr Diet. 2014 Apr;114(4):603-12. doi: 10.1016/j.jand.2013.11.020. Epub 2014 Feb 16.
The effectiveness of community-based participatory research (CBPR) efforts to address the disproportionate burden of hypertension among African Americans remains largely untested. The objective of this 6-month, noncontrolled, pre-/post-experimental intervention was to examine the effectiveness of a CBPR intervention in achieving improvements in blood pressure, anthropometric measures, biological measures, and diet. Conducted in 2010, this multicomponent lifestyle intervention included motivational enhancement, social support provided by peer coaches, pedometer diary self-monitoring, and monthly nutrition and physical activity education sessions. Of 269 enrolled participants, 94% were African American and 85% were female. Statistical analysis included generalized linear mixed models using maximum likelihood estimation. From baseline to 6 months, blood pressure decreased significantly: mean (± standard deviation) systolic blood pressure decreased from 126.0 ± 19.1 to 119.6 ± 15.8 mm Hg, P=0.0002; mean diastolic blood pressure decreased from 83.2 ± 12.3 to 78.6 ± 11.1 mm Hg, P<0.0001). Sugar intake also decreased significantly as compared with baseline (by approximately 3 tsp; P<0.0001). Time differences were not apparent for any other measures. Results from this study suggest that CBPR efforts are a viable and effective strategy for implementing nonpharmacologic, multicomponent, lifestyle interventions that can help address the persistent racial and ethnic disparities in hypertension treatment and control. Outcome findings help fill gaps in the literature for effectively translating lifestyle interventions to reach and engage African-American communities to reduce the burden of hypertension.
社区参与式研究(CBPR)在解决非裔美国人高血压负担过重问题方面的效果在很大程度上尚未得到检验。本 6 个月、非对照、前后实验干预的目的是检验 CBPR 干预在改善血压、人体测量指标、生物学指标和饮食方面的有效性。该多组分生活方式干预于 2010 年进行,包括动机增强、同伴教练提供的社会支持、计步器日记自我监测以及每月营养和身体活动教育课程。在 269 名入组参与者中,94%为非裔美国人,85%为女性。统计分析包括使用最大似然估计的广义线性混合模型。从基线到 6 个月,血压显著下降:平均(±标准差)收缩压从 126.0±19.1 降至 119.6±15.8mmHg,P=0.0002;平均舒张压从 83.2±12.3 降至 78.6±11.1mmHg,P<0.0001)。与基线相比,糖摄入量也显著减少(约减少 3 茶匙;P<0.0001)。其他指标没有明显的时间差异。本研究结果表明,CBPR 努力是实施非药物、多组分生活方式干预的可行且有效的策略,有助于解决高血压治疗和控制方面持续存在的种族和民族差异。结果发现有助于填补文献中的空白,以便有效地将生活方式干预转化为针对减少高血压负担的非裔美国人群体。