FIBER ADHERENCE AND MARKER DEVELOPMENT IN BLACK CHURCHES

这项以社区为基础的患者结局研究的目的是实施一项 护理干预南部黑人成年人，45-75岁， 从低到中上SES，然后评估依从性结果， 开发一种复合粘附标记。记号是一种声音， 护理干预的相对非侵入性依从性测量。 的 干预是一种经过测试的坚持促进战略， 癌症预防模型中的行为。它鼓励消费13.5克 补充膳食麦麸（不溶性）纤维标记为50毫克 核黄素/份。 有患结肠癌年龄风险的参与者 将从南方黑人教堂和周边地区招募 社区100名男性和女性（至少1/3男性）的有目的样本将 接收依从性干预，每个都充当其自己的控制。 将通过以下方式测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（根据日历的依从性 完成）、血液测量和尿核黄素。单独的 依从性指标将单独进行比较， 以尿核黄素为多模态复合粘附标志物， 纤维摄入量的标准测量（“黄金标准”）。复合 将测试粘附标记的适当性（可接受性 参与者、文化相关性和成本效益）;敏感性， 特异性和预测值;有效性和可靠性。探索性 将使用判别函数和逻辑回归分析 为复合标记指数的形成制定决策规则， 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体依从性测量 与年龄，性别和SES的标记物进行事后比较（p <0.05）， 0.01）;内容分析将用于解决 目标。这项探索性研究扩展了该团队正在进行的 研究到另一个群体，即，社会经济地位较低至中等的黑人 在南方教会的基础上，并通过开发坚持标记指数。 主要结果包括：验证标记在南方黑人 人口，以及与护理干预相关的饮食变化， 对结肠癌有潜在的保护作用。 其他成果包括高 对癌症有更好教育的人，结肠癌的一个组成部分， （护理干预）添加到现有的教会为基础的健康计划 （心血管疾病风险降低部分）在黑人社区， 并确定遵守战略的障碍和好处， 参与者整个研究计划的最终目标是 通过增加纤维摄入量预防结肠癌。

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.