The CHANGE program, a 4-month CHW-delivered lifestyle intervention, significantly reduced systolic blood pressure by a mean of 2.5 mmHg (P<0.05) in rural, underserved Non-Hispanic Black adults.
Does a CHW-delivered behavioral lifestyle intervention improve cardiovascular risk factors in rural, underserved Non-Hispanic Black adults?
A CHW-delivered lifestyle intervention significantly improved blood pressure, dietary habits, and physical activity in a rural, underserved Non-Hispanic Black population.
Mean Difference: -2.5
p-value: p=<.05
PURPOSE: To evaluate the implementation and effectiveness of the Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program, an adapted evidence-based cardiovascular disease risk reduction intervention delivered by Community Health Workers (CHW) to rural adults. DESIGN: Hybrid implementation-effectiveness study with a pre-post design. SETTING: North Carolina Federally Qualified Health Center and local health department in a rural, medically underserved area. SAMPLE: Participants (n = 255) included 87% Non-Hispanic Black with a mean age of 57 years; 84% had diagnosed hypertension, 55% had diabetes, and 65% had hypercholesterolemia. INTERVENTION: A CHW-delivered, low-intensity, 4-month behavioral lifestyle intervention promoting a southern-style Mediterranean dietary pattern and physical activity. MEASURES: We measured number and representativeness of participants reached and retained, intervention delivery fidelity, weight, blood pressure, and self-reported dietary and physical activity behaviors. ANALYSIS: Pre-post changes at 4 months were analyzed using paired t-tests. RESULTS: Study participants completed 90% of planned intervention contacts; 87% were retained. Intervention delivery fidelity measures showed participants receiving a mean of 3.5 counseling visits, 2.7 booster calls, and on average completing 1.7 modules, setting 1.8 goals, and receiving 1.3 referrals per visit. There were significant mean reductions in systolic (-2.5 mmHg, P < .05) and diastolic blood pressure (-2.1 mmHg, P < .01); the proportion of participants with systolic blood pressure <130 increased by 7 % points (P = .05), and diastolic pressure <80 by 9 percentage points (P < .01). Dietary behaviors improved significantly with average weekly servings of nuts increased by .5 serving (P < .0001), and fruits and vegetables by .8 daily serving (P < .0001). Physical activity also increased on average by 45 min./week (P < .001). Weight did not change significantly. CONCLUSIONS: The CHANGE program showed both implementation and program effectiveness and adds to the evidence supporting CHW-delivered lifestyle interventions to reduce CVD risk among rural, Non-Hispanic Black, and medically underserved populations.
Samuel‐Hodge et al. (Thu,) conducted a other in Cardiovascular disease risk (n=255). Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program was evaluated on Systolic blood pressure (MD -2.5, p=<.05). The CHANGE program, a 4-month CHW-delivered lifestyle intervention, significantly reduced systolic blood pressure by a mean of 2.5 mmHg (P<0.05) in rural, underserved Non-Hispanic Black adults.