A Cultural Dance Program Improves Hypertension Control and Cardiovascular Disease Risk in Native Hawaiians: A Randomized Controlled Trial.
A Cultural Dance Program Improves Hypertension Control and Cardiovascular Disease Risk in Native Hawaiians: A Randomized Controlled Trial.
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DOI：
10.1093/abm/kaaa127
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发表时间：
2021-10-04
期刊：
影响因子：
--
通讯作者：
de Silva M
中科院分区：
文献类型：
--
作者：
Kaholokula JK;Look M;Mabellos T;Ahn HJ;Choi SY;Sinclair KA;Wills TA;Seto TB;de Silva M
夏威夷原住民的高血压（HTN）和心血管疾病（CVD）发病率高于非西班牙裔白人，呼吁采取文化响应干预措施来缩小这一差距。我们测试了为期6个月的行为干预的效果，这是一种基于草裙舞（夏威夷的传统舞蹈）的文化舞蹈项目，用于改善患有不受控制的HTN的夏威夷土著人的血压（BP）和CVD风险。在一项随机对照试验中，我们在263名患有不受控制的HTN（如果患有糖尿病，则收缩压≥ 140或≥ 130 mmHg）且在招募时没有CVD的夏威夷土著人中测试了基于呼啦的干预的效果。所有参与者在随机分配到基于hula的干预（n = 131）或仅接受教育的候补名单对照（n = 132）之前接受了简短的文化定制的心脏健康教育。干预组接受草裙舞课程和团体活动6个月。对照组在6个月内只接受了1周的教育。从基线到6个月，干预组收缩压（-15.3 mmHg）和舒张压（-6.4 mmHg）的下降幅度大于对照组（分别为-11.8和-2.6 mmHg）（p < .05）。在6个月时，43%的干预参与者与21%的对照组相比，HTN分期<130/80 mmHg（p < .001）。根据Fracket风险评分计算器，干预组的10年CVD风险降低是对照组的两倍。干预参与者的所有改善都维持在12个月。这项试验是少数几个严格进行的土著实践的健康促进，与其他种族人口的影响检查之一。参加文化舞蹈项目的夏威夷土著高血压患者的血压和心血管疾病风险比那些没有参加的人有临床意义的改善。
Native Hawaiians have higher hypertension (HTN) and cardiovascular disease (CVD) rates than non-Hispanic whites, calling for culturally responsive interventions to close this gap. We tested the effects of a 6-month behavioral intervention, a cultural dance program based on hula (the customary dance of Hawai'i), for improving blood pressure (BP) and CVD risk among Native Hawaiians with uncontrolled HTN. In a randomized controlled trial, we tested the effects of the hula-based intervention among 263 Native Hawaiians with uncontrolled HTN (systolic ≥ 140 or ≥ 130 mmHg if diabetes) and no CVD at enrollment. All participants received a brief culturally tailored heart health education before random assignment to the hula-based intervention (n = 131) or the education-only waitlist control (n = 132). Intervention received hula lessons and group-based activities for 6 months. Control received only 1-week education through 6 months. Intervention yielded greater reductions in systolic (−15.3 mmHg) and diastolic (−6.4 mmHg) BP than control (−11.8 and −2.6 mmHg, respectively) from baseline to 6 months (p < .05). At 6 months, 43% of intervention participants compared to 21% of controls achieved a HTN stage <130/80 mmHg (p < .001). The 10-year CVD risk reduction was two times greater for the intervention group than the control group based on the Framingham Risk Score calculator. All improvements for intervention participants were maintained at 12 months. This trial represents one of the few rigorously conducted examinations of an Indigenous practice leveraged for health promotion, with implications for other ethnic populations. Native Hawaiians with hypertension who participated in a cultural dance program show clinically meaningful improvements in blood pressure and cardiovascular disease risk than those who did not participate.
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