Ralston Penny A, Young-Clark Iris, Wickrama Kandauda A S, Coccia Catherine, Lemacks Jennifer L, Battle Arrie M, Hart Celeste, Ilich Jasminka Z
, Center on Better Health and Life for Underserved Populations, Florida State University, P.O. Box 3064191, Tallahassee, FL, 32306-1491, USA.
, Center on Better Health and Life for Underserved Populations, Florida State University, USA.
Contemp Clin Trials Commun. 2022 Aug 18;29:100979. doi: 10.1016/j.conctc.2022.100979. eCollection 2022 Oct.
Cardiovascular disease CVD), the leading cause of death in the U.S., is a particular problem for African Americans (AAs). Church-based health interventions are effective in reducing CVD risk, yet few have been successfully disseminated. This paper describes the model development, preliminary health outcomes, and lessons learned from the Health for Hearts United (HHU) dissemination trial which evolved from the longitudinal Reducing CVD Risk Study in a two-county area in North Florida. Community-based participatory research approaches and the socio-ecological model guided the study.
Data for this paper were from health leaders (n = 25) in the first six churches investigated, and the outreach participants (n = 86) they engaged. Health leaders completed survey items (daily servings of fruits/vegetables [F/V], fat consumption [FAT], and daily minutes of physical activity [PA]) and clinical measures (body mass index [BMI]; waist, hip and abdomen circumferences; and systolic and diastolic blood pressure [BP]). For outreach participants, a brief CVD Awareness Quiz was administered. Data were analyzed using description statistics, Pearson correlations, and repeated measures analysis of variance.
Findings showed that the dissemination model was implemented by 100% of the churches, and resulted in health outcomes changes for health leaders (significant increases between pre- and post-test in F/V; significant decreases in FAT, BMI, abdomen circumference, with educational level and marital status as selected significant covariates) and in a significant increase in CVD awareness for outreach participants. Lessons learned are discussed. Although preliminary, the results suggest that the HHU dissemination model has promise for reducing CVD risk in AA's.
心血管疾病（CVD）是美国的主要死因，对非裔美国人（AA）来说是一个特别严重的问题。基于教会的健康干预措施在降低心血管疾病风险方面是有效的，但很少有措施得到成功推广。本文描述了“心连心健康联盟”（HHU）推广试验的模型开发、初步健康成果以及经验教训，该试验源自佛罗里达州北部两县地区的纵向“降低心血管疾病风险研究”。基于社区的参与性研究方法和社会生态模型指导了这项研究。
本文的数据来自于最初调查的六所教会中的健康领袖（n = 25）以及他们所接触的外展参与者（n = 86）。健康领袖完成了调查项目（水果/蔬菜的每日摄入量[F/V]、脂肪摄入量[FAT]以及每日体育活动分钟数[PA]）和临床测量（体重指数[BMI]；腰围、臀围和腹围；收缩压和舒张压[BP]）。对外展参与者进行了一个简短的心血管疾病认知测验。使用描述性统计、皮尔逊相关性分析和重复测量方差分析对数据进行了分析。
研究结果表明，100%的教会实施了推广模型，并使健康领袖的健康状况发生了变化（F/V的前后测试有显著增加；FAT、BMI、腹围显著下降，教育程度和婚姻状况为选定的显著协变量），外展参与者的心血管疾病认知也显著提高。讨论了经验教训。尽管是初步结果，但这些结果表明，HHU推广模型有望降低非裔美国人的心血管疾病风险。
