Intervention to Influence Behaviors Linked to Risk of Chronic Diseases A Multisite Randomized Controlled Trial With African-American HIV-Serodiscordant Heterosexual Couples
Intervention to Influence Behaviors Linked to Risk of Chronic Diseases A Multisite Randomized Controlled Trial With African-American HIV-Serodiscordant Heterosexual Couples
复制标题
DOI：
10.1001/archinternmed.2011.136
复制
发表时间：
2011-04-25
影响因子：
--
通讯作者：
Bellamy, Scarlett L.
中科院分区：
文献类型：
--
作者：
El-Bassel, Nabila;Jemmott, John B., III;Bellamy, Scarlett L.
背景资料：高发病率和死亡率在非洲裔美国人与行为相关的慢性疾病是有据可查的。方法：我们测试的干预措施，以增加多种健康相关的行为在非洲裔美国人的疗效。在一项多中心随机分组对照试验中，将亚特兰大（格鲁吉亚）、洛杉矶（加州）、纽约（纽约）和费城（宾夕法尼亚）的非裔美国人人类免疫缺陷病毒（HIV）血清不一致的异性恋夫妇分组，接受以个人为中心的健康促进（针对多种健康相关行为）或以夫妇为中心的HIV/性传播疾病（STD）风险降低干预。主要结果是坚持水果和蔬菜的消费和身体活动指南评估干预前，立即干预后，6和12个月后干预。次要结果包括脂肪食物消费，前列腺癌和乳腺癌筛查，以及饮酒。结果：健康促进干预参与者更有可能报告每天食用5份或更多份水果和蔬菜（率比[RR]，1.38; 95%可信区间[CI]，1.18至1.62）和坚持体力活动指南（1.39; 1.22至1.59）与HIV/STD干预参与者相比。与HIV/STD干预相比，在健康促进干预中，参与者食用脂肪食物的频率较低（平均差异，-0.18; 95% CI，-0.30至-0.07），更多男性接受前列腺癌筛查（RR，1.51; 95% CI，1.21至1.88），更多的妇女接受了乳房X光检查（RR，1.26; 95% CI，1.06至1.50）。酒精的使用并没有不同的干预groups.Conclusion：这项试验表明，针对多个健康相关的行为在非洲裔美国人HIV血清阳性和HIV血清阴性的男性和女性的干预措施的疗效。
Background: The high morbidity and mortality in African Americans associated with behavior-linked chronic diseases are well documented.Methods: We tested the efficacy of an intervention to increase multiple health-related behaviors in African Americans. In a multisite cluster-randomized controlled trial, groups of African American human immunodeficiency virus (HIV)-serodiscordant heterosexual couples in Atlanta (Georgia), Los Angeles (California), New York (New York), and Philadelphia (Pennsylvania) were allocated to an individual-focused health promotion that addressed multiple health-related behaviors or to a couple-focused HIV/sexually transmitted disease (STD) risk reduction intervention. Primary outcomes were adherence to fruit and vegetable consumption and physical activity guidelines assessed preintervention, immediately postintervention, and 6 and 12 months postintervention. Secondary outcomes included fatty food consumption, prostate and breast cancer screening, and alcohol use. Generalized estimating equations tested the efficacy of the health promotion intervention over the postintervention assessments.Results: Health promotion intervention participants were more likely to report consuming 5 or more servings of fruits and vegetables daily (rate ratio [RR], 1.38; 95% confidence interval [CI], 1.18 to 1.62) and adhering to physical activity guidelines (1.39; 1.22 to 1.59) compared with HIV/STD intervention participants. In the health promotion intervention compared with the HIV/STD intervention, participants consumed fatty foods less frequently (mean difference, -0.18; 95% CI, -0.30 to -0.07), more men received prostate cancer screening (RR, 1.51; 95% CI, 1.21 to 1.88), and more women received a mammogram (RR, 1.26; 95% CI, 1.06 to 1.50). Alcohol use did not differ between the intervention groups.Conclusion: This trial demonstrates the efficacy of interventions targeting multiple health-related behaviors in African American HIV-seropositive and HIV-seronegative men and women.