Walk Together: A Family-Based Intervention for Hypertension In African Americans

项目摘要/摘要 描述：高血压(HTN)是导致不同种族之间死亡率差异的最大原因 非裔美国人和白人，目前影响到超过一半的非裔美国成年人。尽管 经验支持的HTN自我管理的好处，太少的非裔美国人实现HTN控制，在 部分原因是与白人患者相比，对饮食和锻炼等行为的依从性较低。自我障碍-- 非裔美国人的管理包括有限的健康知识、压力和难以维持 生活方式的改变。家庭成员对HTN的自我管理在这一人群中做出了重大贡献， 然而，家庭支持并没有被当前的HTN自我管理干预所利用。以家庭为基础的自我 利用患者家庭支持网络的管理干预已被证明对其他 慢性疾病。因此，迫切需要经验驱动的以家庭为基础的干预措施，以改善 非裔美国患者HTN的自我管理。拟议的研究将开发一种新的以家庭为基础的 HTN自我管理干预，一起走，改编自现有的经验支持的二元 干预，以便在初级保健中实施。具体地说，我们将(1)开发创新的干预措施 HTN整合了家庭支持对健康结果的影响的理论驱动的研究，以及 在干预的具体细节中以社区为基础的参与性文化观点；以及，(2)确定 步行干预的可行性、可接受性和安全性。拟议的以家庭为基础的干预 将第一个通过合并家庭来针对非裔美国人的HTN自我管理行为 成员既有干预设计，又有直接干预。这项研究的结果将提供关键的 信息使我们更接近确定一起行走对HTN控制的影响，并朝着 为建议的协议提供了可扩展性。

PROJECT SUMMARY/ABSTRACT DESCRIPTION: Hypertension (HTN) is the largest causal factor of racial disparities in mortality between African Americans and Whites, and currently impacts more than half of African American adults. Despite the empirically-supported benefits of HTN self-management, too few African Americans achieve HTN control, in part due to lower adherence to behaviors like diet and exercise, compared to White patients. Barriers to self- management among African Americans include limited health knowledge, stress, and difficulty sustaining lifestyle changes. Family members make substantial contributions to HTN self-management in this population, however, family support is not leveraged by current HTN self-management interventions. Family-based self- management interventions that leverage patients’ family support networks have proven beneficial for other chronic conditions. Thus, there is a critical need for empirically-driven family-based interventions to improve the self-management of HTN for African American patients. The proposed study will develop a novel family-based HTN self-management intervention, Walk Together, adapted from an existing empirically-supported dyadic intervention, for implementation in primary care. Specifically, we will (1) develop an innovative intervention for HTN that integrates theoretically-driven research on family support effects on health outcomes, and community-based participatory cultural perspectives in the specifics of the intervention; and, (2) determine the feasibility, acceptability, and safety of the Walk Together intervention. The proposed family-based intervention will be the first to target the HTN self-management behaviors of African Americans via incorporating family members in both intervention design and directly in the intervention. Results of this study will provide critical information to move us closer to determining the impact of Walk Together on HTN control, and toward scalability for the proposed protocol.