Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.
Division of Health & Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, New York, NY.
Am Heart J. 2014 Mar;167(3):301-7. doi: 10.1016/j.ahj.2013.10.026. Epub 2013 Nov 6.
Uncontrolled hypertension (HTN) is a significant public health problem among blacks in the United States. Despite the proven efficacy of therapeutic lifestyle change (TLC) on blood pressure (BP) reduction in clinical trials, few studies have examined their effectiveness in church-based settings-an influential institution for health promotion in black communities.
Using a cluster-randomized, 2-arm trial design, this study evaluates the effectiveness of a faith-based TLC intervention vs health education (HE) control on BP reduction among hypertensive black adults. The intervention is delivered by trained lay health advisors through group TLC sessions plus motivational interviewing in 32 black churches. Participants in the intervention group receive 11 weekly TLC sessions targeting weight loss, increasing physical activity, fruit, vegetable and low-fat dairy intake, and decreasing fat and sodium intake, plus 3 monthly individual motivational interviewing sessions. Participants in the control group attend 11 weekly classes on HTN and other health topics delivered by health care experts. The primary outcome is change in BP from baseline to 6 months. Secondary outcomes include level of physical activity, percent change in weight, and fruit and vegetable consumption at 6 months, and BP control at 9 months.
If successful, this trial will provide an alternative and culturally appropriate model for HTN control through evidence-based lifestyle modification delivered in churches by lay health advisors.
在美国,黑人中普遍存在不受控制的高血压(HTN)问题,这是一个严重的公共卫生问题。尽管有临床试验证明治疗性生活方式改变(TLC)在降低血压方面的疗效,但很少有研究在教会环境中(黑人社区中促进健康的重要机构)检验其有效性。
本研究采用了群组随机、2 臂试验设计,评估了基于信仰的 TLC 干预与健康教育(HE)对照在降低黑人高血压成年人血压方面的有效性。干预措施由经过培训的非专业卫生顾问通过团体 TLC 会议加动机访谈在 32 家黑人教堂中实施。干预组的参与者接受 11 次每周的 TLC 课程,针对减肥、增加身体活动、水果、蔬菜和低脂奶制品摄入,以及减少脂肪和钠的摄入,另外还有 3 次每月的个人动机访谈。对照组的参与者参加由医疗保健专家提供的关于高血压和其他健康主题的 11 次每周课程。主要结果是从基线到 6 个月时血压的变化。次要结果包括 6 个月时的身体活动水平、体重变化百分比以及水果和蔬菜的摄入量,以及 9 个月时的血压控制情况。
如果成功,该试验将为通过教会中非专业卫生顾问提供的循证生活方式改变来控制高血压提供一种替代且具有文化适应性的模式。