Translating Dietary Trials into the Community

将饮食试验转化为社区

• 批准号: 7686181
• 负责人: Alain Gerald Bertoni
• 金额: $ 22.2万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7686181
• 关键词: 21 year old; Address; Adopted; Adoption; Adult; Affect; African American; American; Anthropology; Antihypertensive Agents; Area; Attitude; Awareness; Behavioral; Belief; Blood Pressure; Books; Church; Communities; Consumption; DASH diet; Data; Data Collection; Development; Diabetes Mellitus; Diet; Diet and Nutrition; Dietary Fats; Eating; Ecology; Education; Educational process of instructing; Effectiveness; Energy Intake; Environmental Risk Factor; Family; Fatty acid glycerol esters; Female; Focus Groups; Food; Goals; Grant; Guidelines; Health; Health Promotion; Healthy People 2010; Heart failure; Home environment; Hypertension; Hypotension; Income; Individual; Intake; Intervention; Joints; Kidney Diseases; Kidney Failure; Knowledge; Life; Life Style; Lipids; Low income; Measures; Medical; Minority; Modeling; Morbid Obesity; National Heart, Lung, and Blood Institute; Neighborhoods; Not Hispanic or Latino; Outcome; Pamphlets; Participant; Pattern; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Prevalence; Process Measure; Qualitative Research; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Research Personnel; Research Project Grants; Research Technics; Resources; Sampling; Self Efficacy; Sodium; Staging; Surveys; Techniques; Testing; Translating; Translations; Transportation; Underweight; Upper arm; Weight; base; cardiovascular risk factor; cerebrovascular; cooking; feeding; food resource; fruits and vegetables; health belief; hypertension control; improved; interest; lifestyle intervention; male; prevent; primary outcome; public health relevance; saturated fat; secondary outcome; skills; tool

DESCRIPTION (provided by applicant): Hypertension (HTN) is a prevalent risk factor for cardiovascular, cerebrovascular, and renal disease, and disproportionately affects African Americans (AA). Although HTN awareness and treatment rates among AA are similar to, or exceed non-Hispanic whites, control of HTN among AAs remains inadequate. Randomized clinical trials have demonstrated the effectiveness of lifestyle measures in lowering BP, including the Dietary Approaches to Stop Hypertension (DASH) diet, which lowers systolic BP 6-14 mmHg. DASH calls for increased consumption of fruits, vegetables, and low fat dairy, and decreased saturated fat and sodium intake. There is limited evidence that DASH has been widely adopted by the public and AA from lower income communities may be less able to adopt DASH as currently disseminated due to barriers related to income, education, attitudes about foods, health beliefs, and neighborhood availability of healthier foods. We propose to utilize quantitative and qualitative research techniques (including focus groups and surveys) to assess environmental, intra-personal, interpersonal and cultural factors that could affect the translation of the DASH diet in a low-income AA community, then utilize the knowledge gathered to adapt existing intervention strategies and tools. These will provide the materials for a randomized three month pilot lifestyle intervention implementing the DASH diet. The 40 participants will be aged 21+ and have pre-HTN or HTN with blood pressure between 120-150/80-95 mmHg on 0,1 or 2 antihypertensive agents, and will be AA residents of Eastern Winston-Salem (a lower-income area whose population is 65 percent AA). We will exclude persons with a medical need for an alternative diet and/or a lower BP goal than 140/90, including persons with diabetes, heart failure, renal failure, morbid obesity (BMI>45) or those who are extremely underweight (BMI<18.5). The intervention arm (20 persons) will consist of 8 group and 2 individual sessions and emphasize the adoption of DASH diet pattern at breakfast, lunch, dinner, snacks, both at home and when dining out. The control arm (20 persons) will receive standard DASH and high blood pressure informational handouts. The primary outcomes of the pilot will be process measures, including participation and dietary change from baseline. This project will provide critical information supporting the development of a community-based intervention promoting the adoption of DASH, which has already been established to be an effective BP lowering strategy in persons with pre-HTN and HTN. Public Health Relevance: The DASH diet is rich in fruits, vegetables, and low fat dairy foods and is known to lower blood pressure in adults. This research project seeks to promote the adoption of the Dietary Approaches to Stop Hypertension (DASH) eating pattern by African American adults with hypertension or prehypertension living in a lower- income minority community.

描述（由申请人提供）：高血压 (HTN) 是心血管、脑血管和肾脏疾病的普遍危险因素，并且不成比例地影响非裔美国人 (AA)。尽管 AA 中的高血压知晓率和治疗率与非西班牙裔白人相似或超过非西班牙裔白人，但 AA 中对高血压的控制仍然不够。随机临床试验已证明生活方式措施在降低血压方面的有效性，其中包括止高血压饮食法 (DASH) 饮食，可将收缩压降低 6-14 mmHg。 DASH 呼吁增加水果、蔬菜和低脂乳制品的摄入量，并减少饱和脂肪和钠的摄入量。有限的证据表明 DASH 已被公众广泛采用，而由于收入、教育、对食品的态度、健康信念和社区是否有更健康食品等方面的障碍，来自低收入社区的 AA 可能不太可能采用目前传播的 DASH。我们建议利用定量和定性研究技术（包括焦点小组和调查）来评估可能影响 DASH 饮食在低收入 AA 社区中转化的环境、个人内部、人际和文化因素，然后利用收集到的知识来调整现有的干预策略和工具。这些将为实施 DASH 饮食的为期三个月的随机试点生活方式干预提供材料。 40 名参与者年龄在 21 岁以上，患有高血压前期或高血压，服用 0.1 或 2 种抗高血压药物后血压在 120-150/80-95 mmHg 之间，并且是东温斯顿-塞勒姆（一个低收入地区，65% 的 AA 人口）的 AA 居民。我们将排除因医疗需要替代饮食和/或血压目标低于 140/90 的人，包括患有糖尿病、心力衰竭、肾衰竭、病态肥胖 (BMI>45) 或体重极轻 (BMI<18.5) 的人。干预组（20 人）将包括 8 个小组和 2 个个人疗程，并强调在早餐、午餐、晚餐、零食、在家和外出就餐时采用 DASH 饮食模式。控制臂（20 人）将收到标准 DASH 和高血压信息讲义。试点的主要成果将是过程测量，包括参与度和相对于基线的饮食变化。该项目将提供关键信息，支持开发基于社区的干预措施，促进 DASH 的采用，DASH 已被确立为高血压前期和高血压患者的有效降压策略。公共健康相关性：DASH 饮食富含水果、蔬菜和低脂乳制品，已知可以降低成人血压。该研究项目旨在促进居住在低收入少数族裔社区的患有高血压或高血压前期的非裔美国成年人采用“控制高血压饮食方法”(DASH) 饮食模式。

项目成果

Translating the Dietary Approaches to Stop Hypertension (DASH) diet for use in underresourced, urban African American communities, 2010.

将控制高血压饮食方法 (DASH) 应用于资源贫乏的城市非裔美国人社区，2010 年。

• DOI: 10.5888/pcd10.120088
• 发表时间: 2013
• 期刊: Preventing chronic disease
• 影响因子: 5.5
• 作者: Whitt-Glover,MeliciaC;Hunter,JaimieC;Foy,CapriG;Quandt,SaraA;Vitolins,MaraZ;Leng,Iris;Hornbuckle,LyndseyM;Sanya,KaraA;Bertoni,AlainG
• 通讯作者: Bertoni,AlainG

A multilevel assessment of barriers to adoption of Dietary Approaches to Stop Hypertension (DASH) among African Americans of low socioeconomic status.

• DOI: 10.1353/hpu.2011.0142
• 发表时间: 2011-11
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Bertoni AG;Foy CG;Hunter JC;Quandt SA;Vitolins MZ;Whitt-Glover MC
• 通讯作者: Whitt-Glover MC