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一项降低围绝经期拉丁裔女性心血管疾病风险的多成分社区参与干预措施:试点研究方案。

A multi-component, community-engaged intervention to reduce cardiovascular disease risk in perimenopausal Latinas: pilot study protocol.

作者信息

Cortés Yamnia I, Berry Diane C, Perreira Krista M, Stuebe Alison, Stoner Lee, Giscombé Cheryl Woods, Crandell Jamie, Santíago Lymarí, Harris Latesha K, Duran Mayra

机构信息

School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC, 27599-7460, USA.

Department of Social Medicine, The University of North Carolina at Chapel Hill, 333 South Columbia Street, MacNider Hall, Campus Box 7240, Chapel Hill, NC, 27599-7240, USA.

出版信息

Pilot Feasibility Stud. 2021 Jan 6;7(1):10. doi: 10.1186/s40814-020-00756-1.

Abstract

BACKGROUND

Cardiovascular disease (CVD) risk increases substantially during perimenopause. Latinas have a significantly worse CVD risk factor profile than non-Hispanic White women, potentially due to multiple sociocultural and environmental factors. To date, interdisciplinary interventions have not focused on improving nutrition, physical activity, stress management, and biologic CVD risk in perimenopausal Latinas. The purpose of this study is to examine the feasibility and initial efficacy of a multi-component intervention to reduce CVD risk in perimenopausal Latinas.

METHODS

This is a two-group, repeated measures experimental study. Eighty perimenopausal Latinas (age 40-55 years) from two community groups will be randomized: one group will complete the intervention; the other will be a wait-list control. The intervention consists of 12-weekly sessions (education, physical activity, stress management, coping skills training), followed by 3 months of continued support, and 6 months of skill maintenance on their own. The primary outcomes include arterial stiffness, blood pressure, lipids, and blood glucose. Secondary outcomes are health behaviors (nutrition, physical activity, sleep, coping strategies), self-efficacy, and other biological factors related to CVD risk (adiposity, C-reactive protein, hair cortisol, vasomotor symptoms). We will assess changes in outcomes from Time 1 (baseline) to Time 2 (6 months) and Time 3 (12 months) using general linear mixed models to test the hypotheses. We will also evaluate the feasibility of the intervention by assessing enrollment and retention rates, barriers, and facilitators to enrollment, intervention fidelity, the suitability of study procedures, and participant satisfaction with the intervention and study protocol. We hypothesize the intervention group will decrease biologic CVD risk and improve health behaviors and self-efficacy significantly more than the wait-list control.

DISCUSSION

Results from this study will contribute to knowledge on the feasibility of behavioral interventions, including stress management and coping skills training, which could reduce CVD burden among perimenopausal Latinas. Because Hispanic/Latinos are the largest ethnic minority in the United States (US), progress regarding CVD risk among perimenopausal Latinas may lead to significant improvement in the overall CVD burden in the US.

TRIAL REGISTRATION

Prospectively registered, NCT04313751 (03/19/2020), Protocol version 1.0.

摘要

背景

围绝经期心血管疾病(CVD)风险大幅增加。拉丁裔女性的CVD危险因素状况明显比非西班牙裔白人女性更差,这可能是由于多种社会文化和环境因素所致。迄今为止,跨学科干预措施尚未侧重于改善围绝经期拉丁裔女性的营养、身体活动、压力管理及生物性CVD风险。本研究的目的是检验一项多组分干预措施降低围绝经期拉丁裔女性CVD风险的可行性和初步疗效。

方法

这是一项两组重复测量的实验性研究。来自两个社区群体的80名围绝经期拉丁裔女性(年龄40 - 55岁)将被随机分组:一组将完成干预;另一组为等待名单对照组。干预包括为期12周的课程(教育、身体活动、压力管理、应对技能培训),随后是3个月的持续支持,以及6个月的自我技能维持。主要结局包括动脉僵硬度、血压、血脂和血糖。次要结局为健康行为(营养、身体活动、睡眠、应对策略)、自我效能感以及与CVD风险相关的其他生物因素(肥胖、C反应蛋白、毛发皮质醇、血管舒缩症状)。我们将使用一般线性混合模型评估从时间1(基线)到时间2(6个月)和时间3(12个月)结局的变化,以检验假设。我们还将通过评估入组率和保留率、入组的障碍和促进因素、干预保真度、研究程序的适用性以及参与者对干预和研究方案的满意度来评估干预的可行性。我们假设干预组在降低生物性CVD风险、改善健康行为和自我效能感方面比等待名单对照组有更显著的效果。

讨论

本研究结果将有助于了解行为干预(包括压力管理和应对技能培训)的可行性,这些干预措施可能减轻围绝经期拉丁裔女性的CVD负担。由于西班牙裔/拉丁裔是美国最大的少数族裔,围绝经期拉丁裔女性在CVD风险方面取得的进展可能会使美国的整体CVD负担得到显著改善。

试验注册

前瞻性注册,NCT04313751(2020年3月19日),方案版本1.0。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cce9/7786946/b1d540acca2b/40814_2020_756_Fig1_HTML.jpg

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