Blood Pressure Control in African Americans
Introduction. Cardiovascular disease is the leading cause of death in the United States (American Heart Association. For African Americans, heart disease ranks as the number one reason for morbidity and mortality and stroke ranks third. Risk factors for heart disease and stroke include elevated blood pressure, cigarette smoking, high cholesterol, excess body weight, sedentary lifestyle and diabetes. Given these health issues in African Americans, Healthy People 2010 recommends community-based health programs that focus on changing dietary and lifestyle behaviors. Church-based health programs are considered a viable strategy for reaching African Americans. Building on the current work in church-based health programming with African Americans, this project will use a family-focused church-based approach to address dietary and lifestyle health, promoting key behaviors which are increasingly linked to disease prevention and reduction of morbidity.
Methodology. Participants from three churches were recruited for the study in a two-county area of North Florida. Each church designated three health leaders (for a total of 9) who received an orientation to the project. Family members (n=17 including 10 adults and 7 children aged 12-18) were then recruited from the churches to participate in “CHECK YOUR HYPErtension,” a weekly two-hour educational session held over nine weeks. The sessions included the following components: a healthy meal, presentation by health providers, hands-on activities, prevention tips, homework assignments, and spiritual moments. A pre/post design without comparison group was used. A self-administered survey developed by the investigators included the National Cancer Institute (NCI) global measure for daily servings of fruits and vegetables and a single to determine minutes of physical activity used in previous studies. Clinical measurements included height, weight, and blood pressure.
Findings. The majority of adult participants were female, 36 to 42 years of age, high school graduates and married. The children were primarily female and ranged in age from 12-18. Results showed that the average fruit and vegetable consumption increased for both the adults (from 2.0 to 3.1, p=.02) and children (from 2.4 to 3.9, p=.07). Daily minutes of physical activity increased 10.7% for adults and 38.8% for children. Child family session participants decreased both systolic and diastolic blood pressure by 4.8% and 2.6% from 115.0 to 109.4 and 72.1 to 70.2, respectively. Adult blood pressure showed very little change from pre-test to post-test (130.5 to 131.6 and 80.9 to 80.0, respectively). Once two participants who had highly variable blood pressure were removed, pre-test/post-test average adult systolic blood pressure (132.6 to 128.1) declined by 3.4% and diastolic blood pressure (79.3 to 77.7) declined by 2%. Although not significant, the trend in the blood pressure outcomes is promising. Weight and BMI’s did not decrease for either the adults or the children.
Conclusions. The findings suggest that a family focused nine-week intensive session may be effective in increasing daily fruit and vegetable consumption, increasing physical activity, and decreasing blood pressure. With a small sample and no comparison group, further research is needed.
Implications for Research/Practice. Using a family approach may be an effective strategy in improving health of African Americans in a church setting.