Faith-Based Approaches in the Treatment of Hypertension (FAITH)

基于信仰的高血压治疗方法 (FAITH)

• 批准号: 8307676
• 负责人: KRISTIE J LANCASTER
• 金额: $ 6.27万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-05 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8307676
• 关键词: Abbreviations; Accounting; Address; Adherence; American Heart Association; Attention; Behavior; Behavior Therapy; Behavioral; Blood Pressure; Blood Pressure Monitors; Body Weight Changes; Body Weight decreased; Body mass index; Cardiovascular Diseases; Cardiovascular system; Church; Communities; Conduct Clinical Trials; Counseling; Diabetes Mellitus; Diastolic blood pressure; Dietary Assessment; Dietary intake; Eating; Effectiveness; Exhibits; Fatty acid glycerol esters; Goals; Health; Health Promotion; Health education; Healthy People 2010; High Prevalence; Hypertension; Hypotension; Individual; Influentials; Institution; Intake; Intervention; Joints; Kidney Diseases; Life Style; Link; Literature; Maintenance; Maps; Measures; Morbidity - disease rate; National Cancer Institute; National Heart, Lung, and Blood Institute; New York City; Outcome; Participant; Patients; Phase; Physical activity; Printing; Procedures; Public Health; Public Health Practice; Publications; Questionnaires; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Self Determination; Sodium; Testing; Therapeutic; Training; Translational Research; Translations; United States National Institutes of Health; Weight; base; behavior change; blood pressure regulation; design; digital; evidence base; fruits and vegetables; hypertension control; hypertension treatment; improved; innovation; lectures; lifestyle intervention; mortality; motivational enhancement therapy; primary outcome; secondary outcome; skills; theories; therapeutic lifestyle change; Abbreviations; Accounting; Address; Adherence; American Heart Association; Attention; Behavior; Behavior Therapy; Behavioral; Blood Pressure; Blood Pressure Monitors; Body Weight Changes; Body Weight decreased; Body mass index; Cardiovascular Diseases; Cardiovascular system; Church; Communities; Conduct Clinical Trials; Counseling; Diabetes Mellitus; Diastolic blood pressure; Dietary Assessment; Dietary intake; Eating; Effectiveness; Exhibits; Fatty acid glycerol esters; Goals; Health; Health Promotion; Health education; Healthy People 2010; High Prevalence; Hypertension; Hypotension; Individual; Influentials; Institution; Intake; Intervention; Joints; Kidney Diseases; Life Style; Link; Literature; Maintenance; Maps; Measures; Morbidity - disease rate; National Cancer Institute; National Heart, Lung, and Blood Institute; New York City; Outcome; Participant; Patients; Phase; Physical activity; Printing; Procedures; Public Health; Public Health Practice; Publications; Questionnaires; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Self Determination; Sodium; Testing; Therapeutic; Training; Translational Research; Translations; United States National Institutes of Health; Weight; base; behavior change; blood pressure regulation; design; digital; evidence base; fruits and vegetables; hypertension control; hypertension treatment; improved; innovation; lectures; lifestyle intervention; mortality; motivational enhancement therapy; primary outcome; secondary outcome; skills; theories; therapeutic lifestyle change

DESCRIPTION (provided by applicant): Hypertension (HTN) accounts for the greatest portion of racial disparities in mortality between blacks and whites. Poor BP control in blacks is attributed to higher prevalence of adverse lifestyle behaviors such as lack of physical activity, high sodium intake, poor intake of fruits and vegetables. Despite compelling evidence of the beneficial effects of therapeutic lifestyle changes (TLC) on BP reduction, their effectiveness in community-based settings remains untested, particularly in churches - an influential institution for health promotion in black communities. We address this gap in the literature by testing the effect of a church-based lifestyle intervention on BP reduction in 400 hypertensive blacks (BP> 140/90 mm hg). The intervention, delivered through group classes and motivational interviewing (MINT-TLC) will be compared to an attention control condition (CC). 20 churches will be randomly assigned equally to either group. We hypothesize that subjects in MINT-TLC group will exhibit at 6 months, greater BP reduction; more physical activity; increased intake of fruits and vegetables; greater within-participant weight reduction; a higher proportion with adequate BP control (9 months). Subjects in the CC group will receive group health education classes that will be delivered by experts on various health topics unrelated to hypertension. In addition to the lectures, participants in the churches randomized to the health education CC condition will receive print versions of the NHLBI publications "Your Guide to Lowering Blood Pressure"; and "Facts about the DASH Eating Plan." Those in the MINT-TLC will attend weekly group classes focused on TLC for 12 weeks (intensive phase); plus monthly individual motivational interviewing sessions for three months (maintenance phase). MINT-TLC is designed to help participants make appropriate TLC and develop skills to maintain these changes long-term. MINT-TLC will be delivered by trained Lay Health Advisors recruited from the churches. The primary outcome is within-subject change in BP from baseline to 6 months. Secondary outcomes are levels of targeted lifestyle behaviors; and proportion with adequate BP control at 9 months (BP<140/90 mm Hg). Regardless of group assignments, all outcomes will be assessed at baseline, 3, 6, and 9 months (for BP control only) with well-validated procedures and measures. BP will be assessed with an automated digital BP monitor. Lifestyle behaviors will be assessed with NCI's brief fruit/vegetable and fat dietary assessment questionnaires and the 7-day physical activity recall. Weight loss will be the difference in weight between baseline and 6 months. The long-term goal is to refine and integrate MINT-TLC into standard practices delivered by LHA in black churches. PUBLIC HEALTH RELEVANCE: If successful, the findings from this study will provide much-needed information on the translation and sustainability of therapeutic lifestyle modification in hypertensive patients in community-based settings, particularly within churches, which represent the most influential institution in the community lives of blacks. We believe that the concept of testing the effectiveness of well-proven efficacious lifestyle interventions in community-based settings utilizing a collaborative partnership approach in addition to a multi-disciplinary team of investigators is innovative and addresses the goals of the NIH road map concerning the translation of research into public health practice.

描述（由申请人提供）：高血压（HTN）是黑人和白人死亡率中种族差异最大的最大部分。黑人中的BP控制不佳归因于不良生活方式行为的较高患病率，例如缺乏体育锻炼，高钠摄入量，水果和蔬菜的摄入量不佳。尽管有令人信服的证据表明，治疗性生活方式改变（TLC）对减少BP的有益影响，但它们在基于社区的环境中的有效性仍未经过测试，尤其是在教会中 - 这是黑人社区健康促进的有影响力的机构。我们通过测试基于教会的生活方式干预对400个高血压黑人（BP> 140/90 mm HG）的BP减少的影响来解决文献中的这一差距。通过小组课程和动机访谈（MINT-TLC）进行的干预措施将与注意力控制条件（CC）进行比较。 20个教堂将被随机分配给两个群体。我们假设Mint-TLC组中的受试者将在6个月时表现出更大的BP降低。更多的体育锻炼；水果和蔬菜的摄入量增加；较大的参与性体重减轻；具有足够的BP对照（9个月）的较高比例。 CC组的受试者将获得小组健康教育课程，这些课程将由专家提供与高血压无关的各种健康主题。除了讲座外，教会的参与者随机与健康教育条件一起将获得NHLBI出版物的印刷版本“您的降低血压指南”；和“关于破折号饮食计划的事实”。在Mint-TLC中，那些将参加TLC上的每周小组课程（密集阶段）；加上每月的个人动机面试会议三个月（维护阶段）。 Mint-TLC旨在帮助参与者制作适当的TLC并发展技能以长期维持这些变化。 Mint-TLC将由教会招募的经过训练的外行健康顾问提供。主要结果是BP从基线到6个月的受试者内部变化。次要结果是有针对性的生活方式行为的水平；并在9个月时以足够的BP对照（BP <140/90 mm Hg）的比例。无论小组分配如何，所有结果都将在基线，3、6和9个月（仅用于BP对照）中评估，并采用验证良好的程序和措施进行评估。 BP将通过自动数字BP监视器进行评估。 NCI的简短水果/蔬菜和脂肪饮食评估问卷以及7天的体育活动回顾将评估生活方式行为。减肥将是基线至6个月之间体重的差异。长期目标是将薄荷-TLC完善并整合到LHA在黑人教堂中提供的标准实践中。公共卫生相关性：如果成功的话，这项研究的发现将提供有关高血压患者在社区环境中，尤其是在教会中，尤其是在教会中，这是黑人社区生活中最有影响力的机构中的高血压患者的治疗生活方式修饰的急需信息。我们认为，测试良好的有效生活方式干预措施在基于社区的环境中采用合作伙伴关系方法的概念除了研究人员的多学科合作伙伴团队外，还涉及NIH路线图的目标，涉及研究研究对公共卫生实践的验证。