THE GOODNEWS (GENES, NUTRITION, EXERCISE, WELLNESS AND SPIRITUALITY) TRIAL: FINDINGS FROM A HEALTH PROMOTION INVENTION ON THE BELIEFS OF AFRICAN AMERICAN ADULTS IN SOUTH DALLAS ON CARDIOVASCULAR DISEASE RISK FACTORS

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2013-04-12

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Ola, Olatunde

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Purpose: Significant disparities persist in the prevalence, morbidity, and mortality associated with cardiovascular diseases (CVD) and major risk factors based on race and ethnicity; the NIH supports risk factor reduction as the most desirable strategy for reducing CVD morbidity and mortality in high-risk populations. Methods: The GoodNEWS Program is a community-based participatory research (CBPR) project among twenty - eight (28) African-American congregations in Dallas, Texas. The partnership has existed for more than ten (10) years with significant community input and engagement. We recently completed a randomized National Institutes of Health (NIH) study, testing the effectiveness of our CBPR partnership on changing health beliefs, eating behavior and increasing physical activity. Results: Baseline data from October 2008 (N=392) indicate that most GoodNEWS participants are overweight (18.7%) or obese (67.3%), and almost one-half (48.3%) have metabolic syndrome. Participants have substantially higher levels of diagnosed disease compared to CDC national averages for African-American adults: heart disease (9.3% vs. 6.1%), diabetes (15.3% vs. 11.8%), high cholesterol (36.3% vs. 14.5%), and high blood pressure (47.5% vs. 31.6%). At the 18-month post-intervention follow-up in April 2010, the intervention group had significant reductions in food energy intake (kcal) (p=.01). However, beliefs about the effects of diet on health outcomes only changed in the control group and not the intervention group. Control participants increased their belief that diet is related to high blood pressure (p=.04), that cholesterol is related to weight gain (p=.017), and that salt intake contributes to high blood pressure (p= .015). Conclusions: The GoodNEWS program demonstrates that a strong community partnership can contribute to reducing CVD risk through food energy intake among African-American adults in the community-congregation setting. However, although intervention participants reduced caloric intake, this was not accompanied by changes in the beliefs of intervention program participants regarding diet and disease outcomes. Indeed, only the control group participants improved their understanding of this relationship. The study did not control for individual-level factors which may have mediated the relationship between the treatment variable and individuals' health beliefs.

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