A review of interventions to reduce health disparities in cardiovascular disease in African Americans.
BACKGROUND
There is a wealth of first- (type or extent) and second- (causes) generation health disparities research. Literature on health disparities interventions (third-generation research) is emerging. In this study, we compiled and qualitatively evaluated interventions to eliminate health disparities in cardiovascular disease (CVD) among African Americans.


METHODS
We reviewed articles published from 1996 through 2006. Inclusion criteria were focus on CVD, African American participants, and intervention, including evaluation data. Two readers evaluated each abstract for including in the full review, and a third reader resolved incongruence. Articles with abstracts that received at least 2 votes for inclusion were reviewed in their entirety by 2 readers. Data were recorded in a Microsoft Access database.


RESULTS
Of 524 abstracts identified, 111 were selected for full review. Only 33 articles were considered third-generation health disparities research by 2 readers and 23 by 1 reader. Approximately half of the interventions were in high-risk populations (low income, low education, urban) and hypertension and nutrition and physical activity were the most common focuses. Of the 33 that received 2 votes, the interventions that received the most enthusiasm from the reviewers used community-based clinics with lay health volunteers. The intensity of the intervention was not correlated with outcome.


CONCLUSIONS
While not widely published, third-generation health disparities research demonstrates interventions to reduce CVD among African Americans. More of this type of research is necessary, and those results must be disseminated.
Crook
Errol D
ED
University of South Alabama Center for Healthy Communities, Mobile, AL 36617-2293, USA. ecrook@usouthal.edu
Bryan
Norman B
NB
Hanks
Roma
R
Slagle
Michelle L
ML
Morris
Christopher G
CG
Ross
Mary C
MC
Torres
Herica M
HM
Williams
R Clay
RC
Voelkel
Christina
C
Walker
Sheree
S
Arrieta
Martha I
MI
D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000150:complications / Q000208:ethnology* / Q000517:prevention & control*; D015438:Health Behavior; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D012307:Risk Factors