COMMUNITY BASED MULTIPLE RISK REDUCTION IN AFRICAN AMERICANS: HEART AND SOUL

基于社区的非洲裔美国人多重风险降低：全心全意

• 批准号: 7630552
• 负责人: EILEEN M STUART-SHOR
• 金额: $ 46.89万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7630552
• 关键词: Adult; African American; Anger; Behavioral; Blood Pressure; Blood Vessels; Body Weight decreased; Boston; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cholesterol; Clinical; Cognitive Therapy; Communities; Condition; Counseling; Country; Effectiveness; End Point; Engineering; Enrollment; Environmental Risk Factor; Exercise; Fasting; Glucose; Goals; Health Priorities; Heart; High Prevalence; Individual; Intervention; Intervention Trial; Measures; Metabolic; Minority Groups; Outcome; Patients; Pattern; Physical activity; Physiological; Policies; Prevalence; Prevention; Preventive; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recruitment Activity; Relaxation Techniques; Risk; Risk Factors; Risk Reduction; Services; Social support; Testing; Trust; Weight; Work; base; biopsychosocial; cohort; community intervention; depressive symptoms; diabetes prevention program; falls; interest; lifestyle intervention; nutrition; prevent; programs; psychosocial; trend; waist circumference

Cardiovascular (CV) disease remains the leading cause of death in this country and the City of Boston, (ref) Of concern, there is compelling evidence that a disproportionate share of the burden of CV disease, and metabolic/vascular risk factors falls on racial and ethnic minorities. [1] [3, 4] Eliminating these disparities is a national and local health priority; and adequate access to culturally appropriate, clinically effective preventive cardiovascular services is important to achieve this goal, (ref) The trend for individuals to have multiple risk factors is increasing[5] and although weight loss and lifestyle interventions have been shown to modify metabolic/vascular abnormalities and CVD risk factors, [3] [6-8] prevalence estimates of these conditions continue to increase, particularly for African Americans.[5] The barriers to effective risk factor reduction are multifactorial, including individual biopsychosocial and environmental factors.[9, 10] The high prevalence of African Americans with known multiple risk factors for CAD, the evidence that modifying risk factors can prevent or modify these conditions and the fact that barriers to effective risk factor reduction are multifactorial, suggests that prevention and risk factor reduction efforts should focus on comprehensive risk reduction strategies in this at-risk group. [5] Our team will test the feasibility of conducting a randomized, non-blinded,'parallel-group, study to assess the outcome of a community based, multiple risk factor diabetes prevention program in an at-risk African American community (Roxbury). The primary aims of the study are to demonstrate the feasibility of recruiting and retaining African American adults to this randomized trial and to describe changes in weight and waist circumference as well as behavioral, psychosocial and physiological endpbints. Recruitment in randomized clinical trials can be difficult in the African American community because of mistrust. This trial arises from several years of community partnership in the community of interest and builds on the trust established in this clinical work. In addition, little is known about the effectiveness, in underserved communities, of communitybased, culturally appropriate, multiple risk reduction interventions. Successful implementation of a community based multiple risk factor reduction program in this underserved and at-risk community has implications for practice and policy.

心血管疾病仍然是这个国家和波士顿的主要死亡原因。 令人担忧的是，有令人信服的证据表明，心血管疾病负担的不成比例，以及 代谢/血管风险因素落在种族和少数族裔身上。[1][3，4]消除这些差距是一个 国家和地方卫生优先事项；充分获得文化上适当的、临床上有效的预防措施 心血管服务对实现这一目标很重要，(参考)个人具有多种风险的趋势 因素正在增加[5]，尽管减肥和生活方式干预已被证明可以改变 代谢/血管异常和心血管危险因素，[3][6-8]这些疾病的患病率估计 继续增加，特别是对于非裔美国人。[5]有效降低风险因素的障碍是 多因素，包括个体生物、心理、社会和环境因素。 已知有多种冠心病风险因素的非裔美国人，证据表明修改风险因素可以 防止或改变这些情况以及有效降低风险因素的障碍是多因素的事实， 建议预防和降低风险因素的工作应侧重于全面降低风险 在这个高危人群中的策略。[5] 我们的团队将测试进行随机、非盲目、平行分组研究的可行性，以评估 一项以社区为基础的多危险因素糖尿病预防计划在高危非裔美国人中的结果 社区(罗克斯伯里)。这项研究的主要目的是论证招募和 保留非洲裔美国成年人参加这项随机试验，并描述体重和腰围的变化 周长以及行为、心理社会和生理方面的端部。在随机化中招募 由于不信任，在非裔美国人社区进行临床试验可能很困难。这场审判是由 在利益共同体中建立了几年的社区伙伴关系，并建立在 临床工作。此外，人们对以社区为基础、服务不足的社区的有效性知之甚少， 文化上适当的、多种降低风险的干预措施。成功实施社区 在这个服务不足和面临风险的社区中，基于多种风险因素的减少计划具有以下意义 实践和政策。