A Community Partnership to Reduce Blood Pressure among African American Adults

描述(由申请人提供)：长期目标是利用基于社区的参与性研究(C6PR)方法来提高社区能力，以促进身体活动和健康的食物选择，并开发基于社区的过程和模式协议，实现在密西西比州哈蒂斯堡的非裔美国成年人中持续降低收缩压(SBP)。这种干预的动机是密西西比州非裔美国人中高血压、肥胖症、缺乏体力活动和心血管疾病的比率是全国最高的，以及社区通过社区合作方法解决这一问题的愿望。具体目标是：1)发展和评估社区促进体力活动和健康食物选择的能力，2)测试为期6个月的CBPR步行干预对所有步行参与者收缩压的治疗效果，以及3)通过电话测试持续激励增强对SBP的治疗效果。通过多项战略解决能力建设问题，以在干预期间加强能力的具体层面，包括参与、领导、技能、资源、网络、批判性反思和社区力量。全面的进程评估将通过多种跟踪方法以及来自所有参与者级别的定性反馈，收集社区能力得到加强的证据。干预阶段包括为期6个月的CBPR步行干预，以降低收缩压，采用单一小组岗前设计，包括以下组成部分：由志愿者步行小组负责人提供的社会支持，由训练有素的干预人员进行的激励性访谈(ML)，计步器日记自我监测，以及每月的教育会议。参与者将在6个月后随机进入为期12个月的小米增强或非增强维持组，小米增强组接受四个毫升的电话咨询会议，以鼓励持续的体力活动。在整个干预和维护阶段，将每隔3至12个月对结果指标进行评估。将每周至每季度对个人、团体和干预水平流程措施进行评估。成功的干预措施将拥有可持续的基础设施，以继续解决健康差距问题，并证明血压的降低对降低心血管疾病的发病率和死亡率具有公共卫生影响。

DESCRIPTION (provided by applicant): Long term objectives are to utilize a community-based participatory research (C6PR) approach to achieve enhanced community capacity to promote physical activity and healthy food choices and to develop a community-based process and model protocol that achieves a sustained reduction in systolic blood pressure (SBP) among African American adults in Hattiesburg, Mississippi. This intervention is motivated by rates of hypertension, obesity, lack of physical activity, and cardiovascular disease among Mississippi African Americans that are among the highest in the nation, and by the community's desire to address this problem through collaborative community approaches. Specific aims are: 1) to develop and assess community capacity to promote physical activity and healthy food choices, 2) to test treatment effects of a 6-month CBPR walking intervention on systolic blood pressure among all walking participants, and 3) to test the treatment effects of a sustained motivational enhancement via telephone on SBP. Capacity building is addressed through multiple strategies to enhance, over the life of the intervention, specific dimensions of capacity including participation, leadership, skills, resources, networks, critical reflection, and community power. A comprehensive process evaluation will capture evidence of enhanced community capacity through multiple tracking methods as well as qualitative feedback from all participant levels. The Intervention Phase consists of a 6-month CBPR walking intervention to lower systolic blood pressure, using a single group pre-post design and including the following components: social support provided by volunteer walking group leaders, motivational interviewing (Ml) by trained intervention staff, pedometer diary self-monitoring, and monthly education sessions. Participants will be randomized at six months into a 12-month Mi enhanced or non-enhanced maintenance group, with Mi-enhanced receiving four Ml telephone counseling sessions to encourage continued physical activity. Outcome measures will be evaluated at three- to 12-month intervals throughout intervention and maintenance phases. Individual, group and intervention level process measures will be evaluated at weekly to quarterly intervals. A successful intervention will have a sustainable infrastructure to continue addressing health disparities and demonstrate a reduction in blood pressure with public health implications for reducing cardiovascular disease morbidity and mortality.