Intervention to influence behaviors linked to risk of chronic diseases: a multisite randomized controlled trial with African-American HIV-serodiscordant heterosexual couples
Nabila El-Bassel, John B Jemmott 3rd, J Richard Landis, Willo Pequegnat, Gina M Wingood, Gail Elizabeth Wyatt, Scarlett L Bellamy, National Institute of Mental Health Multisite HIV/STD Prevention Trial for African-American Couples Group, Nabila El-Bassel, John B Jemmott 3rd, J Richard Landis, Willo Pequegnat, Gina Wingood, Gail E Wyatt, Scarlett L Bellamy, Ralph DiClemente, Louisa Gilbert, Loretta Sweet Jemmott, David Metzger, Hector Myers, Robert H Remien, Susan Witte, Elwin Wu, Lynne Allen-Taylor, Dina Appleby, Shawn Ballard, Trina Brown, Evelyn Crowley, Quincy Greene, Christopher Helker, Nancy Robinson, Angela Ankoma, Deidre Ashton, Tamu Daniel, Cynthia M Green, Dawn A Goddard, Tina Henderson, Inna Rivkin, Reginald Bennett, Nikia D Braxton, Jeffery Brently, Shirley Bryson, Christina Camp, Kevin Chancy, Rebecca D Cheraquit, Anita Conner, Salema Curtis, Jevon Gibson, Deborah Gray, Linda Hakim, Alvin Harmon, Michelle Jones, Phyllis Jones, Teaniese Latham, Frank Levels, Malachi Moore, Charles Patterson, Marcia Penn, Tiffany Pennick-Walters, Rotrease Regan, Elsa Rogers, Kenneth Rucker, Alicia Samuel, Bright Sarfo, Kijana Saunders, Randy Shine, Dawn Simmons, Shammara Steinback, Ralph Stevenson, Robert Tate, Michael Taylor, Nathaniel Thomas, Phillip Williams, Richard Williams, Shauni Williams, Keisha Wilson, Charlotte Wroton, Karen Carter, Calvin Collier, Mikia Croom, Jill Daugherty, Les DeMorst, Deja Er, Linda Felix, Derryck Griffith, Meklit Hailemeskal, Toya Howard, Tamika Hoyte, Pearl Johnson, Lisa Matthews, Rhonda Mendoza, Dionna Samuel, Jamie Smith, Lisa Smith, Joseph Sosa, Brian Taylor, Allan Winkle, Tamara S Bryan, Christina Camp, Lynette Gueits, Tamra Loeb, LaShun Robinson-Simpson, John Williams, Cynthia Bayer, Angela Caliendo, Shalonda Freeman, Jessica Ingersoll, Lisa Maslankowski, Debra McGee-Smith, Patrice Moorer, Michelle Mott, Bennie Woodard, Claudette Bannerman, Warren Blake, Tiffany Bratts, Sonya Combs, Olivia Copeland, Daisy De Jesus-Sosa, Adefunke Faly, Meklit Hailemeskal, Tamika Hoyte, Janet Hsu, Heather Irobunda, Shakaria Johnson, Mathew MacDonald, Frandy Napoleon, Lolita Roy, Dalena White, Karen Williams, Pandora Woods, Crystal Wyatt, Nabila El-Bassel, John B Jemmott 3rd, J Richard Landis, Willo Pequegnat, Gina M Wingood, Gail Elizabeth Wyatt, Scarlett L Bellamy, National Institute of Mental Health Multisite HIV/STD Prevention Trial for African-American Couples Group, Nabila El-Bassel, John B Jemmott 3rd, J Richard Landis, Willo Pequegnat, Gina Wingood, Gail E Wyatt, Scarlett L Bellamy, Ralph DiClemente, Louisa Gilbert, Loretta Sweet Jemmott, David Metzger, Hector Myers, Robert H Remien, Susan Witte, Elwin Wu, Lynne Allen-Taylor, Dina Appleby, Shawn Ballard, Trina Brown, Evelyn Crowley, Quincy Greene, Christopher Helker, Nancy Robinson, Angela Ankoma, Deidre Ashton, Tamu Daniel, Cynthia M Green, Dawn A Goddard, Tina Henderson, Inna Rivkin, Reginald Bennett, Nikia D Braxton, Jeffery Brently, Shirley Bryson, Christina Camp, Kevin Chancy, Rebecca D Cheraquit, Anita Conner, Salema Curtis, Jevon Gibson, Deborah Gray, Linda Hakim, Alvin Harmon, Michelle Jones, Phyllis Jones, Teaniese Latham, Frank Levels, Malachi Moore, Charles Patterson, Marcia Penn, Tiffany Pennick-Walters, Rotrease Regan, Elsa Rogers, Kenneth Rucker, Alicia Samuel, Bright Sarfo, Kijana Saunders, Randy Shine, Dawn Simmons, Shammara Steinback, Ralph Stevenson, Robert Tate, Michael Taylor, Nathaniel Thomas, Phillip Williams, Richard Williams, Shauni Williams, Keisha Wilson, Charlotte Wroton, Karen Carter, Calvin Collier, Mikia Croom, Jill Daugherty, Les DeMorst, Deja Er, Linda Felix, Derryck Griffith, Meklit Hailemeskal, Toya Howard, Tamika Hoyte, Pearl Johnson, Lisa Matthews, Rhonda Mendoza, Dionna Samuel, Jamie Smith, Lisa Smith, Joseph Sosa, Brian Taylor, Allan Winkle, Tamara S Bryan, Christina Camp, Lynette Gueits, Tamra Loeb, LaShun Robinson-Simpson, John Williams, Cynthia Bayer, Angela Caliendo, Shalonda Freeman, Jessica Ingersoll, Lisa Maslankowski, Debra McGee-Smith, Patrice Moorer, Michelle Mott, Bennie Woodard, Claudette Bannerman, Warren Blake, Tiffany Bratts, Sonya Combs, Olivia Copeland, Daisy De Jesus-Sosa, Adefunke Faly, Meklit Hailemeskal, Tamika Hoyte, Janet Hsu, Heather Irobunda, Shakaria Johnson, Mathew MacDonald, Frandy Napoleon, Lolita Roy, Dalena White, Karen Williams, Pandora Woods, Crystal Wyatt
Abstract
Background: The high morbidity and mortality in African Americans associated with behavior-linked chronic diseases are well documented.
Methods: We tested the efficacy of an intervention to increase multiple health-related behaviors in African Americans. In a multisite cluster-randomized controlled trial, groups of African American human immunodeficiency virus (HIV)-serodiscordant heterosexual couples in Atlanta (Georgia), Los Angeles (California), New York (New York), and Philadelphia (Pennsylvania) were allocated to an individual-focused health promotion that addressed multiple health-related behaviors or to a couple-focused HIV/sexually transmitted disease (STD) risk reduction intervention. Primary outcomes were adherence to fruit and vegetable consumption and physical activity guidelines assessed preintervention, immediately postintervention, and 6 and 12 months postintervention. Secondary outcomes included fatty food consumption, prostate and breast cancer screening, and alcohol use. Generalized estimating equations tested the efficacy of the health promotion intervention over the postintervention assessments.
Results: Health promotion intervention participants were more likely to report consuming 5 or more servings of fruits and vegetables daily (rate ratio [RR], 1.38; 95% confidence interval [CI], 1.18 to 1.62) and adhering to physical activity guidelines (1.39; 1.22 to 1.59) compared with HIV/STD intervention participants. In the health promotion intervention compared with the HIV/STD intervention, participants consumed fatty foods less frequently (mean difference, -0.18; 95% CI, -0.30 to -0.07), more men received prostate cancer screening (RR, 1.51; 95% CI, 1.21 to 1.88), and more women received a mammogram (RR, 1.26; 95% CI, 1.06 to 1.50). Alcohol use did not differ between the intervention groups.
Conclusion: This trial demonstrates the efficacy of interventions targeting multiple health-related behaviors in African American HIV-seropositive and HIV-seronegative men and women. Trial Registration clinicaltrials.gov Identifier: NCT00644163.
Figures
Source: PubMed