Engaging NHPIs and Activating Communities to Take Steps (ENACTS)

让 NHPI 参与并激励社区采取措施 (ENACTS)

• 批准号: 9196923
• 负责人: KA'IMI ALOHILANI SINCLAIR
• 金额: $ 21.18万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9196923
• 关键词: 21 year old; Address; Adherence; Adopted; Adoption; Adult; Age; American Heart Association; Antihypertensive Agents; Area; Arts; Awareness; Behavior; Blood Pressure; Body Weight decreased; Car Phone; Cardiovascular Diseases; Clinic; Communities; Control Groups; Data; Diabetes Mellitus; Diagnosis; Diastolic blood pressure; Diet; Dietary Practices; Eating; Education; Educational Curriculum; Educational Intervention; Elements; Energy Metabolism; Enrollment; Exercise; Family; Family member; Feedback; Focus Groups; Food; Geographic Information Systems; Hawaiian population; Health Food; Health education; Heart Diseases; Household; Hypertension; Hypotension; Individual; Intake; Intervention; Interview; Knowledge; Label; Learning; Life Style; Measurement; Measures; Micronutrients; Nutritional; Outcome; Overweight; Pacific Island Americans; Pamphlets; Participant; Patient Self-Report; Pattern; Persons; Pharmaceutical Preparations; Photography; Physical activity; Physical environment; Physicians; Policies; Population; Potassium; Potassium Deficiency; Prevalence; Prevention; Probability; Race; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Risk; Risk Factors; Self Care; Self Efficacy; Self Management; Site; Smoke; Social support; Sodium; Sodium Chloride; Stroke; Stroke prevention; Technology; Text; Time; Translating; Washington; Woman; Work; abstracting; blood pressure reduction; blood pressure regulation; cardiovascular disorder prevention; cardiovascular disorder risk; community center; family support; good diet; health disparity; hypertension control; hypertensive heart disease; improved; informant; medication compliance; modifiable risk; novel; peer; phrases; primary outcome; programs; public health relevance; secondary outcome; smoking cessation; sound; success; sugar; tool; treatment as usual

PROJECT 3 Abstract Hypertension is a strong but modifiable risk factor for cardiovascular disease and stroke. Compared to Whites, Native Hawaiians and Pacific Islanders (NHPIs) are 3 to 4 times more likely to develop these conditions. They also manifest at younger ages among NHPIs, and are more likely to be fatal than in the all-races population. Hypertension prevalence is 70% higher in NHPIs than in Whites, and nearly 50% of NHPIs over the age of 21 have hypertension. Yet, NHPIs are largely absent from research on this topic. Many NHPIs consume diets high in sodium and sugar. Education on self-care for reducing sodium intake, increasing potassium intake, and encouraging weight loss, smoking cessation, and physical activity can improve blood pressure (BP). We will adapt an existing educational intervention to address self-management of hypertension in NHPIs. The multilevel 6-month intervention – “Engaging NHPIs and Activating Communities to Take Steps” (ENACTS) – will operate use peer-facilitated, self-care BP education delivered weekly for 8 weeks emphasizing healthy diet, traditional NHPI foods, adherence to medication, and encouragement to increase physical activity and stop smoking; with text messaging to boost adherence. We will implement ENACTS as a randomized controlled trial at 3 community sites serving NHPIs in the Puget Sound area of Washington. We will randomize 270 NHPI adults (90 per site) with a self-reported physician diagnosis of hypertension and elevated BP measured at enrollment to either ENACTS or usual care. Both groups will receive general health education brochures, plus a $30 weekly credit for online grocery shopping. We will use a Geographic Information Systems (GIS) mobile phone app to track participants. The primary outcome is change in systolic BP. Secondary outcomes are food purchasing behaviors (online ordering, grocery receipts); medication adherence; social support; smoking cessation; and GIS data on daily energy expenditure. Outcomes will be measured at baseline, weekly, and at 6 months. We will also examine change in household food purchasing patterns, enhanced family support for BP control, and BP improvement among family members. A subset of intervention participants and family members will be invited to participate in a program that uses personal photographs for narrative art projects to promote labeling of healthy foods by local retail outlets. Our Specific Aims are: 1) at the individual level, to compare within-person change in BP and secondary outcomes between the intervention and control groups; 2) at the family level, to evaluate ENACTS’ effects on BP and secondary outcomes as within-person change in family members who provide primary support, and as mean change in other adult family members who are not directly engaged in the intervention; and 3) at the policy level, to evaluate the intervention’s ability to influence grocery store policy on clearly identifying foods that are low in sodium or high in potassium, some of which might not be easily identified with existing labels (e.g., fresh produce). ENACTS combines empirically supported elements of existing programs, thus increasing its probability of success. It aligns with the American Heart Association’s call for multilevel prevention.

项目3 抽象的 高血压是心血管疾病和中风的强大但可改变的危险因素。与白人相比 夏威夷原住民和太平洋岛民（NHPIS）发展这些条件的可能性高3至4倍。他们 在NHPIS中也表现出年轻人的年龄，并且比全股票人口更有可能致命。 NHPI的高血压患病率比白人高70％，而NHPI的近50％在21岁以上 有高血压。但是，NHPI在很大程度上缺乏有关该主题的研究。许多NHPI的饮食量很高 在钠和糖中。减少钠摄入量，增加钾的摄入量的自我保健教育以及 鼓励体重减轻，戒烟和体育锻炼可以改善血压（BP）。我们将 适应现有的教育干预措施，以解决NHPI中高血压的自我管理。多级 6个月的干预措施 - “与NHPI和激活社区一起采取措施”（颁布） - 将运作 使用每周进行8周健康饮食的每周提供的同伴自我保健BP教育，传统 NHPI食品，遵守药物以及鼓励增加体育锻炼并停止吸烟；和 文本消息传递以提高依从性。我们将在3个社区中实施作为随机对照试验的颁布 在华盛顿普吉特海湾地区为NHPI提供服务的地点。我们将随机分配270名NHPI成年人（每个站点90） 用自我报告的高血压物理诊断和入学时测量的BP升高到任何一个 制定或通常的护理。两组将获得一般健康教育手册，以及每周30美元的信用 用于在线杂货店购物。我们将使用地理信息系统（GIS）手机应用程序跟踪 参与者。主要结果是收缩压的变化。次要结果是食品购买行为 （在线订购，杂货收据）；药物依从性；社会支持；戒烟；和GIS数据 每日能源消耗。结果将在基线，每周和6个月时测量。我们还将检查 家庭食品购买方式的变化，对BP控制的家庭支持增强以及BP的改进 在家庭成员中。干预参与者和家庭成员将被邀请参加 一项使用个人照片用于叙事艺术项目的计划，以促进当地的健康食品标签 零售店。我们的具体目的是：1）在个人层面上，比较BP和 干预组和对照组之间的次要结果； 2）在家庭一级，评估颁布 作为提供主要支持的家庭成员的人身变化，对BP和次要结果的影响， 作为其他不直接从事干预的成年家庭成员的平均变化； 3） 政策水平，以评估干预措施影响杂货店政策的能力，以清楚识别食物 钠含量低或高钾，其中一些可能不容易与现有标签一起识别（例如， 新鲜农产品）。颁布结合了现有程序的经验支持的要素，从而增加了其 成功的概率。它与美国心脏协会的多层次预防呼吁保持一致。