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.

Keywords: African Americans; Cardiovascular disease; Church-based health promotion.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Fig. 1

Logic model.

Fig. 2

Organizational structure for reducing cardiovascular risk study.

Fig. 3

Sample selection. Inclusion criteria: African American, 45 year of age or older, regular church attendance (2 times a month). Stratification: Gender (to ensure sufficient males) and age (to ensure sufficient 45–64 age group). Exclusion criteria: race other than African American, under 45 years of age, irregular church attendance (less than two times a month).