Culturally Appropriate Storytelling to Improve Blood Pressure A Randomized Trial
Culturally Appropriate Storytelling to Improve Blood Pressure A Randomized Trial
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DOI：
10.7326/0003-4819-154-2-201101180-00004
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发表时间：
2011-01-18
影响因子：
39.2
通讯作者：
Hullett, Sandral
中科院分区：
文献类型：
--
作者：
Houston, Thomas K.;Allison, Jeroan J.;Hullett, Sandral
背景：讲故事正在成为在弱势人群中促进健康的有力工具。然而，这些干预措施在很大程度上还没有在严格的研究中得到检验。目的：测试一种涉及DVD的交互式讲故事干预。设计：随机对照试验，对照患者接受一张注意力控制DVD。对控制或未控制高血压的患者进行了单独的随机分配。(ClinicalTrials.gov注册号：NCT00875225)地点：美国南部市中心的一家安全网诊所。患者：230名患有高血压的非裔美国人。干预：3张DVD，其中包含患者的故事。结果：在2007年12月至2008年5月期间，299名非洲裔美国患者被随机分配，在整个研究过程中，76.9%的患者被保留下来。女性占71.4%，平均年龄53.7岁。两组基线平均收缩压和舒张压相似。在基线未得到控制的高血压患者中，在3个月时，干预组的收缩压(11.21 mm Hg[95%CI，2.51~19.9 mm Hg]；P=0.012)和舒张压(6.43 mm Hg[CI，1.49~11.45 mm Hg]；P=0.012)均降低。基线控制的高血压患者在研究组之间随着时间的推移没有显著差异。两组的血压随后都有所上升，但组间差异保持相对恒定。限制：这是一项单点研究，损失了23%的随访率，只有6个月的随访期。结论：讲故事干预对基线未受控制的高血压患者的血压产生了实质性和显著的改善。主要资金来源：寻找答案：罗伯特·伍德·约翰逊基金会的全国性项目--差异研究。安实习生医院。2011；154：77-84。
Background: Storytelling is emerging as a powerful tool for health promotion in vulnerable populations. However, these interventions remain largely untested in rigorous studies.Objective: To test an interactive storytelling intervention involving DVDs.Design: Randomized, controlled trial in which comparison patients received an attention control DVD. Separate random assignments were performed for patients with controlled or uncontrolled hypertension. (ClinicalTrials.gov registration number: NCT00875225)Setting: An inner-city safety-net clinic in the southern United States.Patients: 230 African Americans with hypertension.Intervention: 3 DVDs that contained patient stories. Storytellers were drawn from the patient population.Measurements: The outcomes were differential change in blood pressure for patients in the intervention versus the comparison group at baseline, 3 months, and 6 to 9 months.Results: 299 African American patients were randomly assigned between December 2007 and May 2008 and 76.9% were retained throughout the study. Most patients (71.4%) were women, and the mean age was 53.7 years. Baseline mean systolic and diastolic pressures were similar in both groups. Among patients with baseline uncontrolled hypertension, reduction favored the intervention group at 3 months for both systolic (11.21 mm Hg [95% CI, 2.51 to 19.9 mm Hg]; P = 0.012) and diastolic (6.43 mm Hg [CI, 1.49 to 11.45 mm Hg]; P = 0.012) blood pressures. Patients with baseline controlled hypertension did not significantly differ over time between study groups. Blood pressure subsequently increased for both groups, but between-group differences remained relatively constant.Limitation: This was a single-site study with 23% loss to follow-up and only 6 months of follow-up.Conclusion: The storytelling intervention produced substantial and significant improvements in blood pressure for patients with baseline uncontrolled hypertension.Primary Funding Source: Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation. Ann Intern Med. 2011;154:77-84.