FIBER ADHERENCE AND MARKER DEVELOPMENT IN BLACK CHURCHES

黑人教堂的纤维粘附和标记物发展

• 批准号: 2257457
• 负责人: JAN R ATWOOD
• 金额: $ 11万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 1996-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2257457
• 关键词: African American; behavior modification; biomarker; blood chemistry; cancer prevention; cancer risk; colon neoplasms; dietary fiber; feces analysis; health behavior; human middle age (35-64); human subject; human therapy evaluation; nursing intervention; nutrition aspect of cancer; nutrition related tag; questionnaires; riboflavin; socioeconomics; therapy compliance

The aim of this community-based, patient outcomes study is to implement a nursing intervention among Southern black adults, 45-75 years of age with lower to upper middle SES, then to assess the adherence outcomes and develop a composite adherence marker. The marker is to be a sound, relatively non-invasive adherence measure of a nursing intervention. The intervention is a tested adherence promotion strategy based on the Health Behavior in Cancer Prevention Model. It encourages consumption of 13.5 g of supplemental dietary wheat bran (insoluble) fiber labelled with 50 mg riboflavin/serving. Participants at age risk for developing colon cancer will be recruited from Southern black churches and the surrounding community. A purposive sample of 100 men and women (at least 1/3 men) will receive the adherence intervention, each acting as their own control. Adherence to the month-long nursing intervention will be measured via multiple biopsychosocial modalities: self-report (adherence per calendar completion), blood measures, and urinary riboflavin. The separate adherence measures will be compared individually and in a combined multimodality, composite adherence marker with urinary riboflavin as the criterion measure of fiber intake ("gold standard"). The composite adherence marker will be tested for its appropriateness (acceptability to participants, cultural relevance, and cost effectiveness); sensitivity, specificity and predictive value; validity and reliability. Exploratory analyses with discriminant function and logistic regression will be used to develop decision rules for composite marker index formation, while assessing sensitivity and specificity. Bivariate correlations among the individual adherence measures with riboflavin levels, t-tests and ANOVA with post hoc comparisons of markers with age, gender, and SES (p less than 0.01); and content analysis will be used to address the rest of the aims. This exploratory study extends the team's ongoing program of research to another population, i.e., blacks with lower to middle SES based in a Southern church and by developing the adherence marker index. Primary outcomes include: validation of markers in a Southern black population, and change in diet related to a nursing intervention which is potentially protective from colon cancer. Other outcomes include high risk people who are better educated about cancer, a colon cancer component (nursing intervention) added to an existing church-based health program (cardiovascular disease risk reduction component) in a black community, and identification of barriers and benefits of the adherence strategy for participants. The ultimate goal of the whole program of research is primary prevention of colon cancer via increased fiber intake.

这项基于社区的患者成果研究的目的是实施 南部黑人成年人的护理干预，45-75岁 中下部SES，然后评估依从性结果和 开发一个复合依从性标记。标记是一个声音， 相对无创的护理干预措施。 这 干预是基于健康的经过测试的依从性促进策略 癌症预防模型的行为。它鼓励消费13.5克 用50 mg标记的补充饮食小麦麸皮（不溶性）纤维 核黄素/服务。 患有结肠癌的年龄风险的参与者 将从南部黑人教堂和周围的环境中招募 社区。有目的的100名男女（至少1/3人）的有目的样本 接受依从性干预，每个干预措施充当自己的控制。 遵守为期一个月的护理干预将通过 多种生物心理社会方式：自我报告（每个日历遵守 完成），血液测量和尿核黄素。独立的 依从性措施将单独比较 多模式，尿核黄素的复合依从性标记 纤维摄入的标准度量（“黄金标准”）。复合材料 依从性标记将进行适当性测试（可接受性 参与者，文化相关性和成本效益）；灵敏度， 特异性和预测价值；有效性和可靠性。探索性 将使用具有判别功能和逻辑回归的分析 制定复合标记索引形成的决策规则，而 评估灵敏度和特异性。双变量相关性 核黄素水平，t检验和方差分析的个人依从性度量 随着年龄，性别和SES的标记后的事后比较（P更少 大于0.01）;内容分析将用于解决其余的 目标。这项探索性研究扩展了团队正在进行的计划 研究另一个人群，即中性SES的黑人 基于南方教会，并通过发展依从性标记指数。 主要结果包括：南部黑色标记的验证 人口以及与护理干预有关的饮食变化 潜在地保护结肠癌。 其他结果包括高 风险对癌症进行更好教育的人，这是结肠癌的成分 （护理干预）添加到现有的基于教会的健康计划中 （心血管疾病降低风险成分）在黑人社区中， 并确定遵守策略的障碍和利益 参与者。整个研究计划的最终目标是 通过增加的纤维摄入来预防结肠癌。