The GOODNEWS (Genes, Nutrition, Exercise, Wellness, and Spiritual Growth) Trial

说明(申请人提供)：在心血管疾病(CVD)风险因素、患病率和健康结果方面，种族和少数民族以及社会经济地位较低的人之间仍然存在显著差异。虽然《2010年健康人》(HP)和国家临床指南支持改变生活方式以预防和降低心血管疾病的流行，但许多障碍限制了许多少数族裔和低收入社区的健康行为改变。需要使用基于社区的参与性研究(CBPR)技术的新的风险降低战略，这使研究人员和社区能够共同努力促进健康、预防疾病和减少健康差距。协作策略必须超越单独调查行为变化，开始专注于行为变化的维护。Good News(基因、营养、运动、健康和精神成长)试验是一项为期18个月的有效性试验，其中包括一项为期18个月的延长维持研究，对象是参加Good News基于信仰的非裔美国人和低收入教会的20个会众。训练结束后，会众将被随机分成两组，一组是健康维持干预的好消息组(Good News-L)，另一组是单纯的好消息组(Good News-PA)。维持干预结合了医疗模式的要素和以社区为基础的支持的特点。主要数据收集将在基线、18个月和36个月进行，两个主要结果是通过7天体力活动回忆(PAR)衡量的体力活动水平和由饮食历史问卷(DHQ)衡量的饮食变化。基本的假设是，与只进行计划的小组相比，维持小组将显著增加身体活动和健康的饮食行为。我们还假设，好消息-L组的脂蛋白和血糖水平以及血压将比基线显著改善，这些变化将显著大于好消息-PA组。在试验结束时，两组都将继续进行为期18个月的延长维护研究。与公共卫生相关：好消息试验与2010年健康人消除健康差距的目标是一致的。改变生活方式是降低高危人群心血管疾病患病率的重要策略。这项拟议的研究将有助于更好地理解以社区为基础的健康促进和初级预防战略，以减少这些人群中心脏病和中风的风险因素，并随着时间的推移保持生活方式和行为的变化。

DESCRIPTION (provided by applicant): Significant disparities in cardiovascular disease (CVD) risk factors, prevalence, and health outcomes persist among racial and ethnic minorities, and those with lower socioeconomic status (SES). Although Healthy People 2010 (HP) and national clinical guidelines endorse lifestyle change for preventing and reducing CVD prevalence, numerous barriers limit health behavior change in many minority and low-income communities. New risk reduction strategies are needed using community-based participatory research (CBPR) techniques, which allow researchers and communities to combine their efforts promoting health, preventing disease, and reducing health disparities. Collaborative strategies must move beyond investigating behavior change alone and begin focusing on behavior change maintenance. The GoodNEWS (Genes, Nutrition, Exercise, and Wellness and Spiritual Growth) Trial is an 18-month effectiveness trial with an 18-month extended maintenance study, among 20 African-American and low- income congregations participating in the GoodNEWS faith-based lay health promotion program. After training, congregations will be randomized to either GoodNEWS with a health maintenance intervention (GoodNEWS-l) or GoodNEWS program alone (GoodNEWS-PA). The maintenance intervention combines elements of the medical care model and features of community-based support. Primary data collection will occur at baseline, 18, and 36 months with the two primary outcomes being levels of physical activity as measured by 7- Day Physical Activity Recall (PAR) and dietary change as measured by the Diet History Questionnaire (DHQ). The primary hypothesis is that the maintenance group will significantly increase physical activity and healthy eating behavior compared to the program only group. We also hypothesize that lipoprotein and glucose levels, and blood pressure will be significantly improved over baseline in the GoodNEWS-l group and that these changes will be significantly greater than in the GoodNEWS-PA group. At the end of the trial, both groups will continue in an 18-month extended maintenance study. Relevance to Public Health: The GoodNEWS Trial is consistent with the Healthy People 2010 goal of eliminating health disparities. Lifestyle change is an important strategy for reducing CVD prevalence in high- risk populations. The proposed study will contribute to greater understanding of community-based health promotion and primary prevention strategies for reducing risk factors for heart disease and stroke in these populations, and maintaining lifestyle and behavior change over time.