ALIVE: A community-research partnership to reduce diet-related chronic disease in African American congregations

ALIVE：社区研究伙伴关系，旨在减少非裔美国人会众中与饮食相关的慢性疾病

• 批准号: 9565797
• 负责人: ELIZABETH B LYNCH
• 金额: $ 77.74万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-27 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9565797
• 关键词: Address; Adult; African American; Area; Attention; Attitude; Behavior; Behavioral; Bible; Biological Markers; Blood Pressure; Cardiovascular Diseases; Carotenoids; Cessation of life; Chicago; Chronic Disease; Church; Clinical; Communities; Consumption; Control Groups; Cost Analysis; Diabetes Mellitus; Diet; Dietary Carotenoid; Dietary Fiber; Dietary Intervention; Educational Intervention; Effectiveness; Enrollment; Ethnic group; Fabaceae; Food; Fruit; Goals; Healthy Eating; Hour; Hypertension; Incidence; Instruction; Intervention; Link; Lipids; Low income; Measurement; Measures; Mediating; Mediator of activation protein; Nuts; Obesity; Outcome Study; Participant; Phase; Pilot Projects; Plasma; Randomized; Randomized Controlled Trials; Reducing diet; Research; Research Design; Research Methodology; Research Personnel; Risk Factors; Self Efficacy; Techniques; Testing; Training; Treatment Efficacy; Vegetables; Weight; arm; base; behavior change; black/white disparity; blood pressure reduction; cardiovascular disorder risk; cardiovascular risk factor; clinically significant; community based participatory research; comparison group; cooking; cost; design; disorder risk; efficacy testing; fruits and vegetables; health disparity; improved; indexing; innovation; intervention effect; intrinsic motivation; member; metropolitan; mortality; mortality disparity; nutrition education; opportunity cost; primary outcome; programs; social norm; success; therapy design

Project Summary/Abstract Low-income African Americans suffer increased risk of cardiovascular disease and death due to high levels of cardiovascular (CVD) risk factors, such as hypertension, diabetes and obesity. Improving diet quality in African Americans could reduce black-white health disparities but dietary interventions have been less successful in African Americans than other groups. ALIVE is a culturally-tailored, church-based diet intervention designed by a partnership of researchers, African American pastors and congregants using a community-based participatory research methodology. The main components of the intervention include a Bible study to increase intrinsic motivation to eat healthier, paired with small group sessions focused on bui lding self-efficacy through nutrition education, cooking instruction and behavior change techniques. All intervention components are delivered by church members in 24 sessions over 9 months. The ALIVE Pilot study resulted in clinically and statistically significant improvements in vegetable consumption, as well as increased diet quality and reductions in weight and blood pressure. The goal of the proposed study is to conduct a 21 -month behavioral clusterrandomizedcontrolledtrialinwhichchurchesarerandomizedtooneoftwoarms:theinterventionarm, which receives ALIVE intervention in year 1 and Money Smart, a financial education intervention, in year 2, or the comparison arm, which receives the interventions in the reverse order. This study design ad dresses the needs of community partners while controlling for a number of possible confounders such as attention. The primary aim of the study is to assess the efficacy of the ALIVE intervention by comparing enrolled congregants from intervention and comparison churches on change in diet quality as measured by the Alternative Healthy Eating Index (AHEI). Secondary study aims are to evaluate the effect of the ALIVE intervention on plasma carotenoids and evaluate potential mediators of change in diet quality, including self-efficacy, intrinsic motivation, attitudes and subjective social norms for eating healthy. Exploratory aims of the study are to evaluatesustainabilityofchangeinAHEIscoreat12monthspost-interventionintheinterventionarm,evaluate the effect of the ALIVE intervention on changes in blood pressure, lipids, and adiposity, and assess the implementation and participant opportunity costs of the ALIVE intervention. The proposed study is the second phase of an integrated program of research aimed at reducing CVD mortality in African American adults. Phase one showed that the ALIVE intervention resulted in a clinically and statistically significant increase in vegetable consumption. Phase 2, the proposed study, will test whether we can expand this effect to overall diet quality among a larger number of churches and when compared to a control group. Phase 3 will be to conduct a larger trial to test the efficacy of this intervention in reducing blood pressure.

项目概要/摘要 由于高水平的心脏病和死亡，低收入非裔美国人患心血管疾病和死亡的风险增加 心血管（CVD）危险因素，如高血压、糖尿病和肥胖。提高非洲人的饮食质量 美国人可以减少黑人与白人的健康差异，但饮食干预在这方面不太成功 非裔美国人比其他群体。 ALIVE 是一种根据文化量身定制、以教会为基础的饮食干预措施，由 由研究人员、非裔美国牧师和会众组成的伙伴关系，使用基于社区的 参与式研究方法。干预的主要内容包括圣经学习，以增加 吃得更健康的内在动机，与专注于通过以下方式建立自我效能的小组会议相结合 营养教育、烹饪指导和行为改变技术。所有干预组件都是 由教会成员在 9 个月内分 24 场会议发表。 ALIVE 试点研究取得了临床和 从统计上看，蔬菜消费量显着改善，饮食质量和 体重和血压降低。拟议研究的目标是进行为期 21 个月的行为研究 整群随机对照试验，其中教会被随机分配到两个组中的一个：干预组， 在第一年接受 ALIVE 干预，在第二年接受 Money Smart（金融教育干预），或 比较臂，以相反的顺序接受干预。这个研究设计广告着装 社区合作伙伴的需求，同时控制一些可能的混杂因素，例如注意力。这 该研究的主要目的是通过比较登记的会众来评估 ALIVE 干预的效果 来自干预和比较教会对替代健康衡量的饮食质量变化的影响 饮食指数（AHEI）。次要研究目的是评估 ALIVE 干预对血浆的影响 类胡萝卜素并评估饮食质量变化的潜在调节因素，包括自我效能、内在 健康饮食的动机、态度和主观社会规范。该研究的探索性目的是 评估干预组干预后 12 个月 AHEI 评分变化的可持续性，评估 ALIVE 干预对血压、血脂和肥胖变化的影响，并评估 ALIVE 干预的实施和参与者机会成本。拟议的研究是第二项 旨在降低非裔美国成年人心血管疾病死亡率的综合研究计划的一个阶段。 第一阶段表明，ALIVE 干预导致临床和统计学上显着增加 蔬菜消费。拟议的研究第二阶段将测试我们是否可以将这种影响扩展到整体饮食 与对照组相比，更多教会的质量。第 3 阶段将进行 一项更大规模的试验来测试这种干预措施在降低血压方面的功效。

项目成果

High Blood Pressure Medication Adherence Among Urban, African Americans in the Midwest United States.

• DOI: 10.1007/s40615-020-00819-2
• 发表时间: 2021-06
• 期刊: Journal of racial and ethnic health disparities
• 影响因子: 3.9
• 作者: Schober DJ;Tate M;Rodriguez D;Ruppar TM;Williams J;Lynch E
• 通讯作者: Lynch E

Heart 2 Heart: Pilot Study of a Church-Based Community Health Worker Intervention for African Americans with Hypertension.

Heart 2 Heart：以教会为基础的社区卫生工作者对患有高血压的非裔美国人进行干预的试点研究。

• DOI: 10.1007/s11121-023-01553-x
• 发表时间: 2023
• 期刊: Prevention science : the official journal of the Society for Prevention Research
• 作者: Lynch,ElizabethB;Tangney,Christy;Ruppar,Todd;Zimmermann,Laura;Williams,Joselyn;Jenkins,LaDawne;Epting,Steve;Avery,Elizabeth;Olinger,Tamara;Berumen,Teresa;Skoller,Maggie;Wornhoff,Rebecca
• 通讯作者: Wornhoff,Rebecca

Physical Function in Midlife and Older Adults From an African American Church-Based Health Screening.

• DOI: 10.1016/j.amepre.2020.12.017
• 发表时间: 2021-06
• 期刊: American journal of preventive medicine
• 影响因子: 5.5
• 作者: Lange-Maia BS;Dugan SA;Crane MM;Williams JL;Epting RSM Sr;Lynch EB
• 通讯作者: Lynch EB