Refining a Church-Based Lifestyle Intervention Targeting African-American Adults at Risk for Cardiometabolic Diseases: A Pilot Study.

Autor:	Zhou YE; Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA., Jackson CD; Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA., Oates VJ; Department of Family and Consumer Sciences, Tennessee State University, Nashville, TN, USA., Davis GW; Ralph H Boston Wellness Center, Tennessee State University, Nashville, TN, USA., Davis C; Walden University, Minneapolis, MN, USA., Takizala ZM; Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA., Akatue RA; Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA., Williams K; Participant and Clinical Interactions Resources, Meharry Medical College, Nashville, TN, USA., Liu J; Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA., Hébert JR; Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA., Patel KA; Department of Public Health, Tennessee State University, Nashville, USA., Buchowski MS; School of Medicine, Vanderbilt University, Nashville, TN, USA., Schlundt DG; Department of Psychology, Vanderbilt University, Nashville, TN, USA., Hargreaves MK; Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA.
Jazyk:	angličtina
Zdroj:	Open journal of epidemiology [Open J Epidemiol] 2017 May; Vol. 7 (2), pp. 96-114. Date of Electronic Publication: 2017 Apr 21.
DOI:	10.4236/ojepi.2017.72009
Abstrakt:	Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m 2 ) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P < 0.001). The baseline PSS score was positively associated with baseline adiposity levels (e.g., weight, β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
Databáze:	MEDLINE
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