Outcomes of a cardiovascular nutrition counseling program in African-Americans with elevated blood pressure or cholesterol level.
OBJECTIVE
To evaluate a cardiovascular nutrition education package designed for African-American adults with a wide range of literacy skills.


METHODS
Comparison of a self-help group and a full-instruction group; each group received nutrition counseling and clinical monitoring every 4 months.


METHODS
Three hundred thirty African-American adults, aged 40 to 70 years, with elevated cholesterol level or high blood pressure were randomly assigned to the self-help or full-instruction group; 255 completed the 12-month follow-up.


METHODS
Counseling to reduce intake of dietary fat, cholesterol, and sodium was based on Cardiovascular Dietary Education System (CARDES) materials, which included food-picture cards, a nutrition guide (self-help and full-instruction group), a video and audiotape series, and 4 classes (full-instruction group only).


METHODS
Changes in lipid levels and blood pressure after 12 months.


METHODS
Primary analyses consisted of repeated-measures analysis of variance to examine effects of time and randomization group on outcomes.


RESULTS
Total cholesterol and low-density lipoprotein cholesterol level decreased by 7% to 8% in the self-help and full-instruction groups of men and women (P < .01). The ratio of total cholesterol to high-density lipoprotein cholesterol (HDL-C) decreased in both groups of women and in the men in the full-instruction group (P < .01). In full-instruction and self-help participants with elevated blood pressure at baseline, systolic blood pressure decreased by 7 to 11 mm Hg and diastolic blood pressure decreased by 4 to 7 mm Hg (P < .01). Outcomes did not differ by literacy scores but were positively related to the reported initial frequency of using CARDES materials.


CONCLUSIONS
These results suggest that periodic nutrition counseling based on CARDES materials used for home study can enhance management of lipid levels and blood pressure in African-American outpatients.
Kumanyika
S K
SK
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia 19104-6021, USA.
Adams-Campbell
L
L
Van Horn
B
B
Ten Have
T R
TR
Treu
J A
JA
Askov
E
E
Williams
J
J
Achterberg
C
C
Zaghloul
S
S
Monsegu
D
D
Bright
M
M
Stoy
D B
DB
Malone-Jackson
M
M
Mooney
D
D
Deiling
S
S
Caulfield
J
J
D000328:Adult; D001741:Black or African American / Q000193:education*; D000368:Aged; D000428:Alcohol Drinking; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003376:Counseling / Q000379:methods*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D052756:Nutritional Sciences / Q000193:education*; D010865:Pilot Projects; D012907:Smoking; D014280:Triglycerides / Q000097:blood; D014743:Videotape Recording
D008076:Cholesterol, HDL; D014280:Triglycerides; D002784:Cholesterol