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年轻非裔美国人心血管疾病风险教育及生活方式干预:一项随机对照试验

Stroke Counseling Intervention for Young Adult African Americans: A Randomized Controlled Trial.

出版信息

Nurs Res. 2023;72(2):83-92. doi: 10.1097/NNR.0000000000000633. Epub 2022 Dec 9.

Abstract

BACKGROUND

African Americans have a higher incidence of early-onset stroke and poorer stroke-related outcomes than other race/ethnic groups.

OBJECTIVES

Our two-arm, randomized controlled trial was implemented to assess efficacy of the nurse-led Stroke Counseling for Risk Reduction (SCORRE) intervention in reducing stroke risk in young African American adults by improving accuracy of perceived stroke risk and lifestyle behaviors (i.e., diet, physical activity, and smoking cessation). Stroke knowledge, behavior change readiness, and perceived competence to live a healthy lifestyle were also explored as secondary outcomes.

METHODS

African Americans aged 20-35 years, recruited from an urban university and surrounding community, were randomized to SCORRE or an attention placebo control group receiving safe sex education. Data were collected pre-intervention, immediate post-intervention, and at 8 weeks. Multilevel models were used for primary outcome analyses.

RESULTS

Participants ( n = 106) were mostly in their mid-20s, female, college students, and averaged about three modifiable stroke risk factors. Compared to the control group, participants in the intervention group had, on average, a significant increase in accuracy of perceived stroke risk post-intervention, a greater change in perceived competence to live healthy, and a greater increase in dietary components at 8 weeks. Significant changes were not found in physical activity and other outcomes.

DISCUSSION

These findings suggest that SCORRE is a promising intervention to reduce stroke risk among young African American adults. Results will inform a more robust, randomized controlled trial of SCORRE to have an age, culture, and gender-focused intervention that effectively reduces stroke risk among African Americans early in life.

摘要

背景

非裔美国人的早发性中风发病率和与中风相关的预后均高于其他种族/族裔群体。

目的

我们实施了一项两臂、随机对照试验,以评估护士主导的中风风险降低咨询(SCORRE)干预在通过提高对中风风险的感知准确性和生活方式行为(即饮食、身体活动和戒烟)来降低年轻非裔美国成年人中风风险方面的疗效。还探讨了中风知识、行为改变准备就绪情况和感知过上健康生活方式的能力作为次要结果。

方法

从一所城市大学及其周边社区招募年龄在 20-35 岁的非裔美国人,将他们随机分配到 SCORRE 或接受安全性行为教育的注意安慰剂对照组。在干预前、干预后即刻和 8 周时收集数据。使用多层次模型进行主要结局分析。

结果

参与者(n=106)主要为 20 多岁的女性,大学生,平均有大约三个可改变的中风危险因素。与对照组相比,干预组参与者在干预后对中风风险的感知准确性平均显著提高,感知过上健康生活的能力显著增强,8 周时饮食成分也显著增加。但在身体活动和其他结果方面没有发现显著变化。

讨论

这些发现表明,SCORRE 是一种有前途的降低年轻非裔美国成年人中风风险的干预措施。研究结果将为更具规模、随机对照的 SCORRE 试验提供信息,该试验旨在为非裔美国人提供年龄、文化和性别针对性的干预措施,以有效降低他们生命早期的中风风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ea1/9991970/3f28c7723e8a/nihms-1846092-f0001.jpg

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