Significant disparities in cardiovascular disease (CVD) risk factors, prevalence, and health outcomes persist among racial and ethnic minorities, and those with lower socioeconomic status (SES). Although Healthy People 2010 (HP) and national clinical guidelines endorse lifestyle change for preventing and reducing CVD prevalence, numerous barriers limit health behavior change in many minority and low-income communities. New risk reduction strategies are needed using community-based participatory research (CBPR) techniques, which allow researchers and communities to combine their efforts promoting health, preventing disease, and reducing health disparities. Collaborative strategies must move beyond investigating behavior change alone and begin focusing on behavior change maintenance. The GoodNEWS (Genes, Nutrition, Exercise, and Wellness and Spiritual Growth) Trial is an 18-month effectiveness trial with an 18-month extended maintenance study, among 20 African-American and low- income congregations participating in the GoodNEWS faith-based lay health promotion program. After training, congregations will be randomized to either GoodNEWS with a health maintenance intervention (GoodNEWS-l) or GoodNEWS program alone (GoodNEWS-PA). The maintenance intervention combines elements of the medical care model and features of community-based support. Primary data collection will occur at baseline, 18, and 36 months with the two primary outcomes being levels of physical activity as measured by 7- Day Physical Activity Recall (PAR) and dietary change as measured by the Diet History Questionnaire (DHQ). The primary hypothesis is that the maintenance group will significantly increase physical activity and healthy eating behavior compared to the program only group. We also hypothesize that lipoprotein and glucose levels, and blood pressure will be significantly improved over baseline in the GoodNEWS-l group and that these changes will be significantly greater than in the GoodNEWS-PA group. At the end of the trial, both groups will continue in an 18-month extended maintenance study. Relevance to Public Health: The GoodNEWS Trial is consistent with the Healthy People 2010 goal of eliminating health disparities. Lifestyle change is an important strategy for reducing CVD prevalence in high- risk populations. The proposed study will contribute to greater understanding of community-based health promotion and primary prevention strategies for reducing risk factors for heart disease and stroke in these populations, and maintaining lifestyle and behavior change over time.
