Reducing cardiovascular disease risk in mid-life and older African Americans: A church-based longitudinal intervention project at baseline

Abstract

Introduction African Americans (AAs) experience higher age-adjusted morbidity and mortality than Whites for cardiovascular disease (CVD). Church-based health programs can reduce risk factors for CVD, including elevated blood pressure [BP], excess body weight, sedentary lifestyle and diet. Yet few studies have incorporated older adults and longitudinal designs. Purposes The aims of this study are to: a) describe a theory-driven longitudinal intervention study to reduce CVD risk in mid-life and older AAs; b) compare selected dietary (fruit and vegetable servings/day, fat consumption), physical activity (PA) and clinical variables (BMI, girth circumferences, systolic and diastolic BP, LDL, HDL, total cholesterol [CHOL] and HDL/CHOL) between treatment and comparison churches at baseline; c) identify selected background characteristics (life satisfaction, social support, age, gender, educational level, marital status, living arrangement and medication use) at baseline that may confound results; and d) share the lessons learned. Methods This study incorporated a longitudinal pre/post with comparison group quasi-experimental design. Community-based participatory research (CBPR) was used to discover ideas for the study, identify community advisors, recruit churches (three treatment, three comparison) in two-counties in North Florida, and randomly select 221 mid-life and older AAs (45+) (n = 104 in clinical subsample), stratifying for age and gender. Data were collected through self-report questionnaires and clinical assessments. Results and conclusions Dietary, PA and clinical results were similar to the literature. Treatment and comparison groups were similar in background characteristics and health behaviors but differed in selected clinical factors. For the total sample, relationships were noted for most of the background characteristics. Lessons learned focused on community relationships and participant recruitment.

The Development of Health for Hearts United: A Longitudinal Church-based Intervention to Reduce Cardiovascular Risk in Mid-life and Older African Americans

“…13 The need to develop the project grew out of local community initiatives to form county-based coalitions that included churches in partnership with local universities and health organizations to address health issues in the north Florida region. 13 This broader context for the project is consistent with the collaborative approach in working with faith-based organizations. The counties targeted for this project were selected because of the high prevalence of CVD risk factors and mortality rates compared with the overall Florida population.…”

“…13 The name for the intervention, HHU, was identified by one of the community stakeholder advisory groups and then adopted by the church steering committees and other advisory groups.…”

“…13 At these meetings, the timeline for the project was discussed and determined. A monthly meeting schedule was adopted for each treatment church.…”

“…These results occurred even though we initiated a very thorough communication strategy that worked very well with getting participants to data collection sessions. 13 The concern by project staff was that this lack of participation would affect the efficacy of the intervention in that content delivered would be inconsistent, thus affecting learning and the move toward health behavior change. Mid-course corrections during the implementation of an intervention are considered a best practice in process evaluation.…”

The Development of a Tracking Tool to Improve Health Behaviors in African American Adults

“…25 The tracking tool was developed to identify a possible health programming component for mid-life and older participants in conjunction with the 18-month intervention developed for the broader project. The Transtheoretical Model of Behavior Change (TTM) was used as the theoretical framework for the intervention.…”