Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA.
Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.
J Racial Ethn Health Disparities. 2020 Dec;7(6):1160-1171. doi: 10.1007/s40615-020-00740-8. Epub 2020 Apr 23.
Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.
需要在有影响力且易于接触的社区环境中开展广泛的健康促进干预措施，以解决非裔美国人（AA）的糖尿病和心血管疾病（CVD）差异问题。大多数 AA 人超重/肥胖，这是糖尿病/CVD 的主要临床风险因素。本研究采用信仰社区参与的方法，探讨了信仰影响转型计划（FIT）的可行性和结果，该计划是一项糖尿病/CVD 筛查、预防和将护理联系起来的试点干预措施，旨在增加 AA 教会人群的体重减轻，为期 8 个月。6 所教堂进行了匹配和随机分组，分为多层次的 FIT 干预组或标准教育对照组。多层次宗教定制 FIT 干预的关键组成部分包括：（a）个人自助材料（例如，风险检查表、承诺卡）；（b）基督教青年会（YMCA）促进的每周一次的 DPP 体重减轻班；（c）教堂服务活动（例如，讲道、回应阅读）；（d）促进健康饮食和体育活动的教堂-社区短信/语音消息。在教堂服务期间进行健康筛查（例如，体重、血压、血糖），以确定有糖尿病/CVD 风险的参与者，并将他们转介到他们教会的 DPP 班和联系护理服务。参与者（使用教堂外展部的 352 名教会成员和社区成员）主要为女性（67%）和超重/肥胖（87%）。总体而言，与对照组相比，FIT 干预组参与者更有可能实现>5 磅的体重减轻（OR=1.6；CI=1.24，2.01）。干预组的 FIT-DPP 参与者实现>5 磅体重减轻的可能性是对照组的 3.6 倍（p<0.07）。接触讲道、短信/电子邮件、小册子、承诺书和海报与>5 磅的体重减轻显著相关。AA 教堂可以通过在高危 AA 教会人群中开展强化减肥成分的糖尿病/CVD 风险降低干预措施，切实增加其覆盖面和影响力。
