META HEALTH - AIM II

元健康 - AIM II

• 批准号: 7609638
• 负责人: PRISCILLA E PEMU
• 金额: $ 8.97万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7609638
• 关键词: African American; Awareness; Caring; Cholesterol; Clinical; Computer Retrieval of Information on Scientific Projects Database; Counseling; Diagnosis; Diet; Evaluation; Exercise Tolerance; Exhibits; Fasting; Focus Groups; Funding; Glucose; Grant; Health; Health behavior; High Density Lipoproteins; Hour; Inflammatory; Institution; Insulin; Intervention; Life Style; Metabolic; Metabolic syndrome; Outcome; Participant; Patients; Pattern; Physicians; Population; Primary Health Care; Protocols documentation; Provider; Psyche structure; Psychosocial Factor; Questionnaires; Randomized; Recommendation; Research; Research Personnel; Resources; Risk Factors; SF-36; Self Efficacy; Self Management; Serum; Social support; Source; Staging; Stress; Telephone; Treadmill Tests; Treatment outcome; United States National Institutes of Health; Upper arm; Week; Weight; bone; cysteine rich protein; depressive symptoms; design; experience; health related quality of life; improved; lifestyle intervention; lipoprotein triglyceride; medication compliance

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. That a culturally sensitive tailored lifestyle intevention will improve outcomes in African Americans with metabolic syndrome compared with usual care in a primary care ssetting. Specific Aims: To promote physician awareness and patient lifestyle interventions to enhance treatment and outcomes of CV risk factors associated with MetS in hypertensive African Americans. To develop and evaluate the effects of a culturally- sensitive self- management lifestyle intervention (LSI) on health behaviors, clinical outcomes and psychosocial factors in hypertensive AA with CV risk factors associated with the MetS. Primary outcome: To determine if participants who receive the LSI intervention demonstrate improved health behaviors over participants randomized to usual care (UC) as exhibited by: increased exercise tolerance test (treadmill), increased PA levels (Mets-h/week from modified Baeke Questionnaire); improved dietary patterns (Block Questionnaire), and improved medication compliance (Hill-Bone Questionnaire). 2b2. Secondary outcomes: To determine if participants who receive the LSI demonstrate improved clinical outcomes over those randomized to UC as exhibited by: lower systolic and diastolic BP, lower weight, improved serum total cholesterol, high density lipoproteins, and triglyceride levels, and improved metabolic and inflammatory profile (fasting glucose, two hour glucose, fasting insulin, HOMA, CRP). 2b3. Tertiary outcomes: To determine if participants who receive the LSI experience improved health- related quality of life (HRQOL) and psychosocial factors over those receiving UC as exhibited by improved overall physical and mental functioning (SF-36), lower perceived stress, lower depressive symptoms, increased social support, increased diet and PA self efficacy, and increased stage of change for PA. Experimental Protocol: Three separate focus groups with six-eight CPN patients diagnosed with the MetS will be conducted to determine acceptance of the content of the intervention and correspondence with the needs of the population, preferred styles of materials, perceived barriers/benefits of participating in the intervention, and perceived barriers/benefits for improved health behaviors. A two-arm, parallel-group, multi-center design will be used to randomize subjects within the CPN to usual care (UC) or the LSI intervention. Participants randomized to UC will receive usual care from their provider, and will be given a MetS resource folder consisting of information and healthy lifestyle recommendations. Participants randomized to the LSI group will receive UC plus six group sessions designed to improve PA, diet and medication compliance, followed by 10 phone counseling sessions by a CHW. Baseline, three, six and twelve month evaluations will be completed for both groups.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 与初级保健机构的常规护理相比，具有文化敏感性的定制生活方式干预将改善患有代谢综合征的非裔美国人的治疗结果。 具体目标：提高医生意识和患者生活方式干预，以加强与高血压非裔美国人 MetS 相关的 CV 危险因素的治疗和结果。 开发和评估文化敏感的自我管理生活方式干预 (LSI) 对患有与 MetS 相关的心血管危险因素的高血压 AA 的健康行为、临床结果和心理社会因素的影响。 主要结果：确定接受 LSI 干预的参与者是否表现出比随机接受常规护理 (UC) 的参与者改善的健康行为，具体表现为：运动耐量测试（跑步机）增加、PA 水平增加（改良 Baeke 问卷中的 Mets-h/周） ）；改善饮食模式（块问卷），并改善用药依从性（Hill-Bone 问卷）。 2b2.次要结果：确定接受 LSI 的参与者是否比随机接受 UC 的参与者表现出更好的临床结果，具体表现如下：收缩压和舒张压降低，体重减轻，血清总胆固醇、高密度脂蛋白和甘油三酯水平改善，代谢和甘油三酯水平改善。炎症特征（空腹血糖、两小时血糖、空腹胰岛素、HOMA、CRP）。 2b3.第三个结果：确定接受 LSI 的参与者是否比接受 UC 的参与者体验到健康相关的生活质量 (HRQOL) 和心理社会因素的改善，表现为整体身心功能的改善 (SF-36)、感知压力的降低、抑郁的降低症状、增加社会支持、增加饮食和 PA 自我效能以及增加 PA 变化阶段。 实验方案：将由 6-8 名诊断为 MetS 的 CPN 患者组成三个独立的焦点小组，以确定干预内容的接受程度以及与人群需求的对应性、首选材料风格、参与的感知障碍/好处干预措施以及改善健康行为的障碍/益处。将采用双臂、平行组、多中心设计将 CPN 内的受试者随机分配至常规护理 (UC) 或 LSI 干预。随机分配到 UC 的参与者将接受其提供者提供的常规护理，并将获得一个包含信息和健康生活方式建议的 MetS 资源文件夹。随机分配到 LSI 组的参与者将接受 UC 治疗以及旨在改善 PA、饮食和药物依从性的 6 次小组会议，随后由社区卫生工作者进行 10 次电话咨询。两组的基线、三个月、六个月和十二个月评估都将完成。