Heart Healthy and Ethnically Relevant (HHER) Lifestyle trial for improving diet and physical activity in underserved African American women.
BACKGROUND
African American women are at increased risk for CVD morbidity and mortality relative to white women. Physical inactivity and poor dietary habits are modifiable health behaviors shown to reduce CVD risk. Community health centers have the potential to reach large numbers of African Americans to modify their risk for CVD, yet few lifestyle counseling interventions have been conducted in this setting.


METHODS
The HHER Lifestyle trial is a randomized controlled trial to compare the effects of a standard care intervention (provider counseling, nurse goal setting, and educational materials) to a comprehensive intervention (standard care intervention plus 12 months of telephone counseling and tailored print materials) on changes in physical activity and dietary fat consumption in financially disadvantaged African American women at 6 and 12 months. Secondary outcomes are body mass index, central adiposity, and total cholesterol. Potential mediators of outcome are self-efficacy for overcoming barriers, social support, and decisional balance.


RESULTS
African American women (N=266; 130 standard care, 136 comprehensive intervention) 35 years and older from nine clinics within two community health centers were enrolled. Most participants were overweight or obese with existing chronic health conditions.


CONCLUSIONS
The HHER Lifestyle trial is unique in that it targets financially disadvantaged African American women from community health centers, incorporates a standard care intervention into a routine clinical appointment, and includes a comprehensive process evaluation. The design will permit further research examining the added effect of regular telephone counseling and tailored print materials to a primary care provider and nurse intervention.
Parra-Medina
Deborah
D
Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX 78230, USA. parramedina@uthscsa.edu
Wilcox
Sara
S
Wilson
Dawn K
DK
Addy
Cheryl L
CL
Felton
Gwen
G
Poston
Mary Beth
MB
D001741:Black or African American; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000517:prevention & control*; D003131:Combined Modality Therapy; D003376:Counseling; D004041:Dietary Fats / Q000008:administration & dosage; D015444:Exercise; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D050177:Overweight / Q000628:therapy; D010174:Pamphlets; D020377:Self Efficacy; D013689:Telephone; D035862:Vulnerable Populations
D004041:Dietary Fats