Heart 2 Heart: Pilot Study of a Church-Based Community Health Worker Intervention for African Americans with Hypertension.
Heart 2 Heart: Pilot Study of a Church-Based Community Health Worker Intervention for African Americans with Hypertension.
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Heart 2 Heart：以教会为基础的社区卫生工作者对患有高血压的非裔美国人进行干预的试点研究。
DOI：
10.1007/s11121-023-01553-x
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Wornhoff,Rebecca
中科院分区：
文献类型：
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作者：
Lynch,ElizabethB;Tangney,Christy;Ruppar,Todd;Zimmermann,Laura;Williams,Joselyn;Jenkins,LaDawne;Epting,Steve;Avery,Elizabeth;Olinger,Tamara;Berumen,Teresa;Skoller,Maggie;Wornhoff,Rebecca
非裔美国人(AA)的高血压患病率高于白人，这导致预期寿命缩短。在AAS中实现血压控制的障碍包括对医疗保健的不信任以及对药物和饮食建议的较差遵守。我们进行了一项以教会为基础的社区卫生工作者(CHW)干预的试点研究，通过提供支持和策略来改善饮食和药物依从性，以降低AA的血压。为了增加信任和文化和谐，我们雇用和培训教会成员担任社区卫生工作者。血压控制不佳的AA成年人(n= 79人)是从芝加哥一个低收入、隔离社区的教堂招募的。参与者在6个月内平均与CHW一起就诊7.5次。参与者的平均收缩压变化为 − 5 mm/Hg(p= 0.029)。在基线血压较高的参与者(n= 45)中变化更大(− 9.2，p= 0.009)。服药依从性在随访中增加，这主要是由于药物补充的及时性提高了，但对DASH饮食的依从性略有下降。干预的保真度很低。CHW访问的记录显示，CHW没有严格遵守干预方案，特别是在帮助参与者制定行为改变行动计划方面。参与者对干预的可接受性和适当性给出了很高的评分，对实现干预行为目标的可行性给出了略低的评分。参与者重视在他们的教堂进行干预，并且更喜欢基于教会的干预，而不是在临床环境中进行的干预。以教会为基础的CHW干预可能在降低AA患者的血压方面有效。
African Americans (AAs) have higher prevalence of uncontrolled hypertension than Whites, which leads to reduced life expectancy. Barriers to achieving blood pressure control in AAs include mistrust of healthcare and poor adherence to medication and dietary recommendations. We conducted a pilot study of a church-based community health worker (CHW) intervention to reduce blood pressure among AAs by providing support and strategies to improve diet and medication adherence. To increase trust and cultural concordance, we hired and trained church members to serve as CHWs. AA adults (n= 79) with poorly controlled blood pressure were recruited from churches in a low-income, segregated neighborhood of Chicago. Participants had an average of 7.5 visits with CHWs over 6 months. Mean change in systolic blood pressure across participants was − 5 mm/Hg (p= 0.029). Change was greater among participants (n= 45) with higher baseline blood pressure (− 9.2,p= 0.009). Medication adherence increased at follow-up, largely due to improved timeliness of medication refills, but adherence to the DASH diet decreased slightly. Intervention fidelity was poor. Recordings of CHW visits revealed that CHWs did not adhere closely to the intervention protocol, especially with regard to assisting participants with action plans for behavior change. Participants gave the intervention high ratings for acceptability and appropriateness, and slightly lower ratings for feasibility of achieving intervention behavioral targets. Participants valued having the intervention delivered at their church and preferred a church-based intervention to an intervention conducted in a clinical setting. A church-based CHW intervention may be effective at reducing blood pressure in AAs.