Reducing Cardiovascular Disease Risk in Mid-life and Older African Americans

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DESCRIPTION (provided by applicant): Mid-life and older African Americans (AAs), a population that is increasing in number, have higher rates of cardiovascular-related morbidity and mortality than Whites, particularly in relation to dietary and physical activity behaviors. Few tested health promotion interventions tailored for mid-life and older AAs are available yet churches have been shown to be an effective environment for AA health programs. Thus, the overall goal of this project is to reduce cardiovascular disease (CVD) risk factors in mid-life and older AAs through implementing and evaluating a church-based health intervention. Using the Transtheoretical Model of Behavior Change (TTM), this project seeks to: 1) determine the effectiveness of a church-based intervention in relation to dietary behaviors (food choice, dietary quality) and habitual physical activity (PA) toward subsequent improvement in CVD risk factors of mid-life and older AAs. Specifically, the intervention will focus on increasing consumption of fruits, vegetables and calcium-rich foods; decreasing consumption of fat, sugar and sodium; increasing habitual PA, all geared to improving selected clinical outcomes (blood lipids, blood pressure, body weight, among others); 2) identify the differentia) influence of program components of the intervention; 3) examine variables that might mediate the process of goal achievement; and 4) determine variables that are related to stage of change progression in goal achievement Midlife and older AAs (n=300) from four churches, two treatment and two comparison, in North Florida will be .selected for the study. The intervention, to be developed using a community-based participatory approach, will include literature-based conceptual elements of awareness building, clinical learning and efficacy development. Instruments will include a food and lifestyle habits questionnaire (food frequency, NCI fruit and vegetable screener, NCI fat screener, physical activity items, TTM items, background characteristics). Cinical data and 3-day dietary records, will be collected from subsample (n=100). Data will be collected at four points: before, 2-times during and after the intervention. The project will be guided by an Advisory Committee (research and community advisors). Diseases such as hypertension and stroke affect mid-life and older African Americans at higher rates than Whites, negatively affecting health status of this group. This project will determine effectiveness of a faith-based intervention to improve health in mid-life and older African Americans.