Heart Disease, Hypertension, Obesity and Obesity-related Medical Conditions, Type 2 Diabetes
Conditions
Brief summary
African Americans have higher rates of diabetes, obesity, heart disease, and high blood pressure. In addition, middle-aged non-Hispanic Black adults develop multiple chronic conditions (MCCs) at an earlier age, which share most of the same risk factors, including poor diet and physical inactivity. The major goal of the proposed project is to develop a culturally tailored intervention focused on improving awareness, knowledge, diet quality, and physical activity in a cohort of AA adults with MCCs.
Detailed description
Chronic diseases and their risk factors are more common and severe for African Americans (AAs) and other racial and ethnic minority groups. The CDC reports that non-Hispanic Blacks are 30% more likely to have high blood pressure and twice as likely as White adults to be diagnosed with diabetes and heart disease or suffer a stroke. In addition, middle-aged non-Hispanic Black adults have higher levels of chronic disease burden and develop multiple chronic conditions (MCCs) at an earlier age. Since chronic diseases share most of the same risk factors, including poor diet and physical inactivity, the inherent potential exists for prevention. Food is Medicine refers to a spectrum of services and health interventions that recognize and respond to the critical link between nutrition and chronic illness. By addressing nutritional needs within the context of health care, Food is Medicine interventions play an important role in preventing and/or managing many of the chronic conditions that drive health care costs. In addition, social support is a key factor influencing health behavior change and aids in successful weight loss, weight management, and obesity program adherence. Thus, this project proposes to pilot a 12-week Food is Medicine intervention with a 3-month follow-up to improve awareness, knowledge, and healthy lifestyle behaviors - primarily nutrition and physical activity in a cohort of AA adults with MCCs. The proposed project will focus on health equity in that it will include nutrition education, interactive cooking demonstrations, the provision of healthy food, and organized walking groups necessary for improved rates of behavior change and the formation of new habits. The proposed project aims to improve physical activity and dietary intakes that influence diabetes, high blood pressure (directly linked to kidney health), and cardiovascular health that disproportionately affect the AA community.
Interventions
BEHAVIORALNutrition Matters
The intervention will consist of two components: educational sessions and a structured PA component. The primary purpose of the educational sessions is to increase experimental group participants' scientific knowledge and skills in healthy cooking and eating. NUTRITION-MATTERS includes weekly 1.5-hour education sessions for a total of 12 weeks. The sessions will be sequenced carefully to blend brief lectures by experts, experience sharing by participants, and an interactive cooking demonstration. All participants will be provided with $20 of food that corresponds to the cooking demonstration and recipes in the participant handbook.The curriculum will include evidence based information on managing chronic diseases with nutrition and will be culturally tailored to include foods, music, and/or same race/ethnicity role models.
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
University of North Carolina, Chapel Hill
Winston Salem State University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
35 Years to 64 Years
Healthy volunteers
No
Inclusion criteria
* African American * Age 35-64 years old * must have been diagnosed with pre diabetes or diabetes and have one other diagnosed chronic condition, including obesity (BMI \>35), hypertension, and heart disease.
Exclusion criteria
* Individuals with a medical condition that interferes with their ability to modify their diet or engage in physical activity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dietary Intake | From enrollment to 3 months following the 12 week intervention (24 weeks) | 24-hour Dietary Recalls |
| Hemoglobin a1c | From enrollment to 3 months following the 12 week intervention (24 weeks) | Hemoglobin a1c |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Waist circumference | From enrollment to 3 months following the 12 week intervention (24 weeks) | Waist circumference in inches |
| Blood pressure | From enrollment to 3 months following the 12 week intervention (24 weeks) | Blood pressure was measured via sphygmomanometer |
| Eating Behaviors | From enrollment to 3 months following the 12 week intervention (24 weeks) | Three-Factor Eating Questionnaire-Revised 18-Item Version |
| Qualitative Data | 3 months following the 12 week intervention | Focus groups will be conducted to collect qualitative data. Research questions that will guide the focus groups are 1\) What are the perceived barriers to healthy eating and accessing nutritious foods? (2) What intervention and cultural factors impact nutritional and physical activity behavioral changes in AAs? (3) What types of support aided in program adherence and behavioral changes? |
| Lipid Profile | From enrollment to 3 months following the 12 week intervention (24 weeks) | Levels of LDL, HDL, total cholesterol, and triglycerides were measured |
| Body Weight | From enrollment to 3 months following the 12 week intervention (24 weeks) | Body Weight in pounds |
Countries
United States
Outcome results
None listed