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结果研究的目的是实施 对 45-75 岁南方黑人成年人的护理干预 中下SES，然后评估依从性结果 开发复合粘附标记。标记是声音， 护理干预的相对非侵入性依从性测量。 这 干预是一种基于健康的经过测试的依从性促进策略 癌症预防模型中的行为。鼓励消费13.5克 标有 50 毫克的补充膳食麦麸（不溶性）纤维 核黄素/份。 处于患结肠癌年龄风险的参与者 将从南部黑人教堂及周边地区招募 社区。 100 名男性和女性（至少 1/3 男性）的有目的样本将 接受依从性干预，每个人都充当自己的对照。 将通过以下方式衡量对为期一个月的护理干预的依从性 多种生物心理社会模式：自我报告（遵守每个日历 完成）、血液测量和尿核黄素。分开的 依从性措施将进行单独比较和综合比较 以尿核黄素为多模态、复合依从性标记物 纤维摄入量的标准衡量标准（“黄金标准”）。复合材料 将测试依从性标记的适当性（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 将使用判别函数和逻辑回归进行分析 制定复合标记指数形成的决策规则，同时 评估敏感性和特异性。之间的双变量相关性 通过核黄素水平、t 检验和方差分析进行个体依从性测量 对标记与年龄、性别和社会经济地位进行事后比较（p 小于 小于0.01）；内容分析将用于解决其余问题 目标。这项探索性研究扩展了团队正在进行的计划 对另一个人群的研究，即社会经济地位中低的黑人 以南方教会为基地，并开发了遵守标记指数。 主要结果包括： 南方黑人标记的验证 人口以及与护理干预相关的饮食变化 具有预防结肠癌的潜在作用。 其他结果包括高 对癌症（结肠癌的一种成分）接受过更好教育的人面临风险 （护理干预）添加到现有的基于教会的健康计划中 （降低心血管疾病风险部分）在黑人社区， 并确定遵守策略的障碍和好处 参与者。整个研究计划的最终目标是 通过增加纤维摄入量来一级预防结肠癌。