HEALTH PROMOTION THROUGH BLACK CHURCHES

这是一项在非裔美国人(AA)中进行的关于文化敏感的自助营养和体力活动干预的有效性的随机对照试验，通过动机访谈的方法实施了持续咨询和不持续咨询，以维持目标健康行为。在亚特兰大黑人教堂的批准和协助下，这项试验设计了三个实验条件：第一组(比较=C)将接受标准化的营养和运动干预(即商业上可获得的营养和运动视频、盒式磁带步行计划和印刷材料)；第二组(TX1)将接受包括营养和运动组成部分的文化敏感的自助干预。营养部分将主要包括《为生命而吃》录像带和食谱(由研究人员为亚特兰大AA社区正在进行的相关试验制作)、一套宣传运动的录像带和录音带(《与上帝同行》将沿着宗教主题开发，并将以类似于为生命而吃的方式在AA焦点小组中进行预先测试)、一份季度通讯和其他具有文化敏感性的营养和锻炼材料。第三组(Tx2)将接受与第二组相同的干预，外加4个基于激励性访谈的电话咨询电话。干预的锻炼部分将强调步行。教会，而不是个人，将被分配到条件，教堂将是分析的单位。15个教会将参与这项研究，并将在随机之前根据教派、规模和收入将三胞胎配对。为了最大限度地利用人员和资源，并改进我们的征聘程序，将在为期两年的干预阶段分几个部分重叠的周期实施干预措施。共有950名受试者将参与这项研究(约60/教堂)。所有参与者将在参与的教堂举行的健康集市上招募。这项研究的干预目标和主要结果是：a)在TX1组与C组以及TX2组与TX1组中，通过每天供应水果和蔬菜来增加水果和蔬菜的摄入量；b)在TX1组与C组以及TX2组与TX1组中，每周增加20分钟的体力活动。饮食结果将通过食物频率问卷和24小时召回在50%的子样本中进行评估。体力活动将通过七天的回忆以及20%的子样本中的心血管健康(自行车测功仪)进行评估。招募和留住参与者将通过几项战略最大化，包括对每个教会的激励，以及利用教会联络人协助参与者招募和跟踪。

This is a randomized controlled trial among African Americans (AA) of the effectiveness of a culturally sensitive self-help nutrition and physical activity intervention, implemented with and without ongoing counseling for maintenance of target health behaviors by the method of Motivational Interviewing. Conducted with the approval and assistance of Atlanta Black churches, the trial is designed with three experimental conditions: Group 1 (Comparison=C) will receive a standardized nutrition and exercise intervention (i.e., commercially available nutrition and exercise videos, audio cassette walking program, and print materials); Group 2 (Tx1) will receive a culturally sensitive self-help intervention that includes nutrition and exercise components. The nutrition component will consist mainly of a the Eat For Life video and cookbook (developed by the investigators for a related ongoing trial with the input of the AA community in Atlanta), a video and audiotape set promoting exercise ("Walk With God" to be developed along religious themes and pretested in AA focus groups in a fashion similar to the Eat for Life), a quarterly newsletter and other culturally sensitive nutrition and exercise materials. Group 3 (Tx2) will receive the same intervention as Group 2, plus 4 telephone counseling calls based on Motivational Interviewing. The exercise component of the intervention will emphasize walking. Churches, rather than individuals, will be assigned to conditions, and churches will be the unit of analysis. Fifteen churches will participate in this study and will be matched in triplets based on denomination, size and income prior to randomization. To maximize use of personnel and resources and allow for refinement of our recruitment procedures, the interventions will be implemented in several partially overlapping cycles over the 2-year intervention phase. A total of 950 subjects will participate in the study (approx. 60/church). All participants will be recruited at health fairs conducted in participating churches. The goals of the interventions and primary outcomes for the study are: a) to increase fruit and vegetable consumption by serving-a-day in Group Tx1 vs C and in Tx2 vs Tx1; b) increase physical activity by 20 minutes per week in Group Tx1 vs C and in Tx2 vs Tx1. Dietary outcomes will be assessed with food frequency questionnaires plus 24-hour recalls in a 50 percent subsample. Physical activity will be assessed with a seven-day recall as well as cardiovascular fitness (cycle ergometer) in a 20 percent subsample. Recruitment and retention of participants will be maximized by several strategies including incentives for each church, and the use of church liaisons to assist in participant recruitment and tracking.