Shah Snehal N, Digenis-Bury Eleni, Russo Elizabeth T, O'Malley Shannon, Blanding Nineequa, McHugh Anne, Wada Roy
Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States.
Department of Pediatrics, Boston University School of Medicine, 850 Harrison Ave, Boston, MA 02116, United States.
Prev Med Rep. 2018 Feb 8;10:66-71. doi: 10.1016/j.pmedr.2018.02.003. eCollection 2018 Jun.
Well documented, persistent racial/ethnic health disparities in obesity and hypertension in the US demonstrate the continued need for interventions that focus on people of color who may be at higher risk. We evaluated a demonstration project funded by the CDC's Racial/Ethnic Approaches to Community Health (REACH) program at four federally qualified health centers (FQHC) and YMCA fitness and wellness centers in Boston. No-cost YMCA memberships were offered from June 2014 to June 2015 to non-Latino black and Latino adults with a diagnosis of hypertension. YMCA visit data were merged with health data for 224 participants ( = 1265 health center visits). We assessed associations between gym visit frequency and weight, body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) using longitudinal time-varying linear fixed-effects models. The total number of gym visits over the entire program duration was 5.5, while the conditional total number of visits (after the first gym visit has been made) was 17.3. Having visited the gym at least 10 times before an FQHC exam was, on average, associated with lower weight (1.19 kg, = 0.01), lower BMI (0.43 kg/m, = 0.01) and reductions in SBP (-3.20 mm Hg, = 0.01) and DBP (-2.06 mm Hg = 0.01). Having visited the gym an average of 1.4 times per month (study average) was associated with reductions in weight, BMI, and DBP. No-cost gym visits were associated with improved weight and blood pressure in hypertensive non-Latino black and Latino adults in this program. Additional evaluation is necessary to assess the sustainability of these effects.
在美国,肥胖和高血压方面存在着有充分记录的、持续的种族/族裔健康差异,这表明持续需要开展针对可能面临更高风险的有色人种的干预措施。我们评估了一个由美国疾病控制与预防中心(CDC)的社区健康种族/族裔方法(REACH)项目资助的示范项目,该项目在波士顿的四个联邦合格健康中心(FQHC)以及基督教青年会(YMCA)健身与健康中心开展。在2014年6月至2015年6月期间,向被诊断患有高血压的非拉丁裔黑人和拉丁裔成年人提供了免费的YMCA会员资格。YMCA的就诊数据与224名参与者的健康数据(=1265次健康中心就诊)进行了合并。我们使用纵向时变线性固定效应模型评估了健身房就诊频率与体重、体重指数(BMI)、收缩压(SBP)和舒张压(DBP)之间的关联。在整个项目期间,健身房就诊的总数为5.5次,而条件就诊总数(在首次到健身房就诊之后)为17.3次。在FQHC检查前至少去过健身房10次,平均而言,与体重降低(1.19千克,=0.01)、BMI降低(0.43千克/米,=0.01)以及SBP降低(-3.20毫米汞柱,=0.01)和DBP降低(-2.06毫米汞柱,=0.01)相关。平均每月去健身房1.4次(研究平均值)与体重、BMI和DBP的降低相关。在该项目中,免费的健身房就诊与高血压非拉丁裔黑人和拉丁裔成年人的体重和血压改善相关。需要进行额外评估以评估这些效果的可持续性。