Schulz Amy J, Israel Barbara A, Mentz Graciela B, Bernal Cristina, Caver Deanna, DeMajo Ricardo, Diaz Gregoria, Gamboa Cindy, Gaines Causandra, Hoston Bernadine, Opperman Alisha, Reyes Angela G, Rowe Zachary, Sand Sharon L, Woods Sachiko
University of Michigan School of Public Health, Ann Arbor, MI, USA
University of Michigan School of Public Health, Ann Arbor, MI, USA.
Health Educ Behav. 2015 Jun;42(3):380-92. doi: 10.1177/1090198114560015. Epub 2015 Mar 27.
The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health (WYHH) intervention, one component of the multilevel Community Approaches to Cardiovascular Health: Pathways to Heart Health (CATCH:PATH) intervention designed to promote physical activity and reduce cardiovascular risk among non-Hispanic Black and Hispanic residents of Detroit, Michigan. The study was designed and implemented using a community-based participatory research approach that actively engaged community residents, health service providers and academic researchers. It was implemented between 2009 and 2012.
WYHH was a 32-week community health promoter-facilitated walking group intervention. Groups met three times per week at community-based or faith-based organizations, and walked for 45 to 90 minutes (increasing over time). The study used a cluster randomized control design to evaluate effectiveness of WYHH, with participants randomized into intervention or lagged intervention (control) groups. Psychosocial, clinical, and anthropometric data were collected at baseline, 8, and 32 weeks, and pedometer step data tracked using uploadable peisoelectric pedometers.
Participants in the intervention group increased steps significantly more during the initial 8-week intervention period, compared with the control group (β = 2004.5, p = .000). Increases in physical activity were associated with reductions in systolic blood pressure, fasting blood glucose, total cholesterol, waist circumference and body mass index at 8 weeks, and maintained at 32 weeks.
The WYHH community health promoter-facilitated walking group intervention was associated with significant reductions in multiple indicators of cardiovascular risk among predominantly Hispanic and non-Hispanic Black participants in a low-to-moderate income urban community. Such interventions can contribute to reductions in racial, ethnic, and socioeconomic inequities in cardiovascular mortality.
本研究旨在评估“让心脏走向健康”（WYHH）干预措施的效果。WYHH是多层次社区心血管健康方法：心脏健康之路（CATCH:PATH）干预措施的一个组成部分，该干预措施旨在促进密歇根州底特律市非西班牙裔黑人和西班牙裔居民的身体活动并降低心血管疾病风险。本研究采用基于社区的参与性研究方法进行设计和实施，该方法积极让社区居民、卫生服务提供者和学术研究人员参与其中。研究于2009年至2012年实施。
WYHH是一项为期32周、由社区健康促进者推动的步行小组干预措施。各小组每周在社区组织或宗教组织碰面三次，步行45至90分钟（随着时间推移逐渐增加）。本研究采用整群随机对照设计来评估WYHH的效果，参与者被随机分为干预组或滞后干预（对照）组。在基线、第8周和第32周收集心理社会、临床和人体测量数据，并使用可上传的压电式计步器跟踪计步数据。
与对照组相比，干预组参与者在最初8周的干预期内步数显著增加更多（β = 2004.5，p = .000）。身体活动的增加与第8周时收缩压、空腹血糖、总胆固醇、腰围和体重指数的降低相关，并在第32周时保持。
在一个中低收入城市社区中，由社区健康促进者推动的WYHH步行小组干预措施与主要为西班牙裔和非西班牙裔黑人参与者的多种心血管疾病风险指标的显著降低相关。此类干预措施有助于减少心血管疾病死亡率方面的种族、族裔和社会经济不平等现象。
