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

描述（由申请人提供）：中年和老年非裔美国人（AA）的心血管相关发病率和死亡率高于白人，特别是在饮食和体力活动行为方面。很少有经过测试的健康促进干预措施，为中年和老年人AA是可用的，但教会已被证明是AA健康计划的有效环境。因此，该项目的总体目标是通过实施和评估以教会为基础的健康干预措施，减少中年和老年AA的心血管疾病（CVD）风险因素。使用行为改变的跨理论模型（TTM），该项目旨在：1）确定基于教会的干预与饮食行为（食物选择，饮食质量）和习惯性体力活动（PA）相关的有效性，以改善中年和老年AA的CVD风险因素。具体而言，干预措施将侧重于增加水果、蔬菜和富含钙的食物的消费;减少脂肪、糖和钠的消费;增加习惯性PA，所有这些都旨在改善选定的临床结果。（血脂、血压、体重等）; 2）确定干预方案组成部分的不同影响; 3）检查可能介导目标实现过程的变量;和4）确定与目标实现的变化进展阶段相关的变量。将选择来自北佛罗里达的四个教会的中年和老年AA（n=300）进行研究，其中两个是治疗组，两个是对照组。将采用基于社区的参与性方法制定的干预措施将包括基于文献的认识建设、临床学习和功效发展的概念要素。工具将包括食物和生活习惯问卷（食物频率、NCI水果和蔬菜筛选器、NCI脂肪筛选器、体力活动项目、TTM项目、背景特征）。将从子样本（n=100）中收集临床数据和3天饮食记录。将在四个时间点收集数据：干预前、干预期间和干预后两次。该项目将由一个咨询委员会（研究和社区顾问）指导。高血压和中风等疾病影响中年和老年非裔美国人的比率高于白人，对这一群体的健康状况产生负面影响。该项目将确定基于信仰的干预措施的有效性，以改善中年和老年非裔美国人的健康状况。

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.