Multibehavior Intervention to Increase Screening and Enhance Risk Reduction in Bl

在美国，黑人男性因高血压（HTN）而过早死亡和残疾的负担最大。 由于国家低血压（BP）控制率。改善血压控制会导致心血管（CV）风险 可以通过治疗性生活方式改变（TLC）来实现。尽管已经证明了 TLC在大型临床试验中，TLC在基于社区的环境中基本上未在该人群中进行测试。CRC是一个 是黑人男性癌症死亡的主要原因，死亡率比白色男性高50%。虽然 一些方法已经成功地提高了少数群体的CRC筛查率，但很少有重点 在非实践社区环境中提高黑人男性的CRC筛查率。我们将 通过评估两种循证干预措施的有效性，解决文献中的差距 专注于黑人男性的血压降低和CRC筛查。目标人群为480名50岁以上的黑人男性 患有不受控制的HTN（BP >135/85 mm Hg）和需要CRC筛查的患者。我们假设黑色 年龄> 50岁的男性，随机接受动机访谈（MINT）生活方式干预， 6个月时，与随机分配至CRC患者导航干预组的患者相比，BP较低。 或者，黑人男性随机分配到CRC干预将有显着较高的CRC筛查 6个月时与随机分配至MINT干预组的患者相比，MINT生活方式的受试者 干预条件将参加1个一对一的咨询，然后是8个基于电话的MINT会议，每两周一次 前2个月，然后每月4个月。那些在CRC干预将收到一个人 还有两个健康导航员的电话主要结局为（1）患者内 收缩压和舒张压从基线至6个月的变化，以及（2）结直肠癌筛查率， 在6个月时通过结肠镜检查或初级保健提供者的FIT报告确定。BP将通过以下方式进行评估： 符合AHA指南的自动数字血压监测仪。CRC筛查将自行报告并验证 通过医疗记录和/或结肠镜检查或提供者的FIT报告。长期目标是一个新的非传统的 在黑人男性中传播降低CV风险和预防CRC的干预措施的模式。

Black men have the greatest burden of premature death and disability from hypertension (HTN) in the United States due to a low blood pressure (BP) control rate. Improving BP control leads to cardiovascular (CV) risk reduction and can be achieved through therapeutic lifestyle changes (TLC). Despite the proven efficacy of TLC in large clinical trials, TLC in community-based settings is largely untested in this population. CRC is a major cause of cancer death in black men, with a death rate that is 50% higher than in white men. Though some methods have been successful in increasing CRC screening rates in minority groups, few have a focus on increasing CRC screening rates among black men in a non-practice community -based setting. We will address the gaps in the literature by evaluating the effectiveness of two evidence-based interventions focused on BP reduction and CRC screening in black men. The target population is 480 black men aged >50 years with uncontrolled HTN (BP >135/85 mm Hg) and in need of CRC screening. We hypothesize that black men, aged > 50 years randomized to a motivational interviewing (MINT) lifestyle interven-tion will have significantly lower BP compared to those randomized to the CRC patient navigation interven-tion at 6 months. Alternatively, black men randomized to the CRC intervention will have significantly higher CRC screening rates compared to those randomized to the MINT intervention at 6 months. Subjects in the MINT lifestyle intervention condition will attend 1 one-on-one counseling followed by 8 phone-based MINT sessions biweekly for the first 2 months then monthly for 4 months. Those in the CRC intervention will receive one inperson and two phone contacts with health navigators. The primary outcomes will be (1) within-patient change in systolic and diastolic BP from baseline to 6 months and (2) colorectal cancer screening rates as determined by colonoscopy or FIT report from the primary care provider at 6 months. BP will be assessed by an automated digital BP monitor meeting AHA guidelines. CRC screen-ings will be self-reported and verified by medical records and/or colonoscopy or FIT reports from providers. The long-term goal is a new nontraditional model of disseminating interventions for CV risk reduction and CRC prevention in black men.