Halbert Chanita Hughes, Bellamy Scarlett, Briggs Vanessa, Delmoor Ernestine, Purnell Joseph, Rogers Rodney, Weathers Benita, Johnson Jerry C
Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Ralph H. Johnson Veteran Administration Medical Center, Charleston, SC 29425, USA.
Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, USA.
Health Educ Res. 2017 Jun 1;32(3):207-218. doi: 10.1093/her/cyx039.
Obesity and excess weight are significant clinical and public health issues that disproportionately affect African Americans because of physical inactivity and unhealthy eating. We compared the effects of alternate behavioral interventions on obesity-related health behaviors. We conducted a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. Outcomes variables were physical activity (PA) and fruit and vegetable intake. Outcomes were evaluated at baseline and 1-month following interventions about shared risk factors for cancer and cardiovascular disease (CVD) (integrated, INT) or CVD only (disease-specific). Significant increases were found in the proportion of participants who met PA guidelines from baseline (47.4%) to follow-up (52.4%) (P = 0.005). In the stratified analysis that were conducted to examine interaction between education and intervention group assignment, this effect was most apparent among participants who had ≤high school education and were randomized to INT (OR = 2.28, 95% CI = 1.04, 5.00, P = 0.04). Completing the intervention was associated with a 1.78 odds of meeting PA guidelines (95% CI = 1.02, 3.10, P = 0.04). Education about risk factors for chronic disease and evidence-based strategies for health behavior change may be useful for addressing obesity-related behaviors among African Americans.
肥胖和超重是重大的临床和公共卫生问题，由于缺乏身体活动和不健康饮食，非裔美国人受到的影响尤为严重。我们比较了不同行为干预对肥胖相关健康行为的影响。我们在一个由530名成年非裔美国人组成的社区样本中进行了一项比较有效性教育试验。结果变量为身体活动（PA）和水果及蔬菜摄入量。在关于癌症和心血管疾病（CVD）共同风险因素（综合干预，INT）或仅关于CVD（疾病特异性干预）的干预措施实施后，于基线和1个月时对结果进行评估。从基线（47.4%）到随访（52.4%），达到PA指南的参与者比例显著增加（P = 0.005）。在进行的分层分析中，为检验教育与干预组分配之间的相互作用，这种效应在≤高中教育水平且被随机分配到INT组的参与者中最为明显（OR = 2.28，95% CI = 1.04，5.00，P = 0.04）。完成干预与达到PA指南的1.78倍几率相关（95% CI = 1.02，3.10，P = 0.04）。关于慢性病风险因素的教育以及基于证据的健康行为改变策略可能有助于解决非裔美国人中与肥胖相关的行为问题。
