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将心脏病生活方式干预措施推广至社区:南亚心脏生活方式干预(SAHELI)研究;一项随机对照试验。

Translating a heart disease lifestyle intervention into the community: the South Asian Heart Lifestyle Intervention (SAHELI) study; a randomized control trial.

作者信息

Kandula Namratha R, Dave Swapna, De Chavez Peter John, Bharucha Himali, Patel Yasin, Seguil Paola, Kumar Santosh, Baker David W, Spring Bonnie, Siddique Juned

机构信息

Department of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA.

Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.

出版信息

BMC Public Health. 2015 Oct 16;15:1064. doi: 10.1186/s12889-015-2401-2.

Abstract

BACKGROUND

South Asians (Asian Indians and Pakistanis) are the second fastest growing ethnic group in the United States (U.S.) and have an increased risk of atherosclerotic cardiovascular disease (ASCVD). This pilot study evaluated a culturally-salient, community-based healthy lifestyle intervention to reduce ASCVD risk among South Asians.

METHODS

Through an academic-community partnership, medically underserved South Asian immigrants at risk for ASCVD were randomized into the South Asian Heart Lifestyle Intervention (SAHELI) study. The intervention group attended 6 interactive group classes focused on increasing physical activity, healthful diet, weight, and stress management. They also received follow-up telephone support calls. The control group received translated print education materials about ASCVD and healthy behaviors. Primary outcomes were feasibility and initial efficacy, measured as change in moderate/vigorous physical activity and dietary saturated fat intake at 3- and 6-months. Secondary clinical and psychosocial outcomes were also measured.

RESULTS

Participants' (n = 63) average age was 50 (SD = 8) years, 63 % were female, 27 % had less than or equal to a high school education, one-third were limited English proficient, and mean BMI was 30 kg/m2 (SD ± 5). There were no significant differences in change in physical activity or saturated fat intake between the intervention and control group. Compared to the control group, the intervention group showed significant weight loss (-1.5 kg, p-value = 0.04) and had a greater sex-adjusted decrease in hemoglobin A1C (-0.43 %, p-value <0.01) at 6 months. Study retention was 100 %.

CONCLUSIONS

This pilot study suggests that a culturally-salient, community-based lifestyle intervention was feasible for engaging medically underserved South Asian immigrants and more effective at addressing ASCVD risk factors than print health education materials.

TRIAL REGISTRATION

NCT01647438, Date of Trial Registration: July 19, 2012.

摘要

背景

南亚人(印度裔和巴基斯坦裔)是美国增长第二快的种族群体,患动脉粥样硬化性心血管疾病(ASCVD)的风险增加。这项试点研究评估了一项基于社区的、具有文化特色的健康生活方式干预措施,以降低南亚人患ASCVD的风险。

方法

通过学术机构与社区的合作,将有ASCVD风险且医疗服务不足的南亚移民随机纳入南亚心脏生活方式干预(SAHELI)研究。干预组参加了6次互动小组课程,重点是增加身体活动、健康饮食、控制体重和压力管理。他们还接受了后续的电话支持。对照组收到了关于ASCVD和健康行为的翻译印刷教育材料。主要结局是可行性和初始疗效,通过3个月和6个月时中度/剧烈身体活动和饮食中饱和脂肪摄入量的变化来衡量。还测量了次要的临床和心理社会结局。

结果

参与者(n = 63)的平均年龄为50岁(标准差 = 8),63%为女性,27%的教育程度低于或等于高中,三分之一的人英语水平有限,平均体重指数为30 kg/m²(标准差 ± 5)。干预组和对照组在身体活动或饱和脂肪摄入量的变化方面没有显著差异。与对照组相比,干预组在6个月时体重显著减轻(-1.5 kg,p值 = 0.04),糖化血红蛋白的性别调整后下降幅度更大(-0.43%,p值 <0.01)。研究保留率为100%。

结论

这项试点研究表明,一项基于社区的、具有文化特色的生活方式干预措施对于吸引医疗服务不足的南亚移民是可行的,并且在解决ASCVD风险因素方面比印刷健康教育材料更有效。

试验注册

NCT01647438,试验注册日期:2012年7月19日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adc1/4609098/4bc5dce2fe20/12889_2015_2401_Fig1_HTML.jpg

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