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）方法来增强社区促进体育活动和健康食品选择的能力，并开发基于社区的过程和模型协议，以实现密西西比州哈蒂斯堡非洲裔美国成年人收缩压（SBP）的持续降低。这项干预措施的动机是密西西比州非裔美国人的高血压、肥胖、缺乏体育活动和心血管疾病的发病率在全国名列前茅，并且社区希望通过社区合作的方式解决这一问题。具体目标是：1)发展和评估社区促进身体活动和健康食物选择的能力；2)测试6个月CBPR步行干预对所有步行参与者收缩压的治疗效果；3)测试通过电话持续动机增强对收缩压的治疗效果。能力建设是通过多种战略来解决的，以在干预的整个生命周期内加强能力的具体维度，包括参与、领导、技能、资源、网络、批判性反思和社区权力。全面的过程评估将通过多种跟踪方法以及来自所有参与层面的定性反馈，获取社区能力增强的证据。干预阶段包括为期6个月的CBPR步行干预以降低收缩压，采用单组前后设计，包括以下组成部分：步行志愿者组长提供的社会支持，训练过的干预人员进行的动机性访谈（Ml），计步器日记自我监测，以及每月的教育课程。参与者将在6个月时随机分为12个月的Mi增强组和非Mi增强组，Mi增强组接受4毫升电话咨询，以鼓励持续的身体活动。在整个干预和维持阶段，每隔3至12个月对结果进行评估。个人、团体和干预水平的过程措施将以每周或每季度的间隔进行评估。成功的干预措施将具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.