Long term objectives are to utilize a community-based participatory research (C6PR) approach to achieve enhanced community capacity to promote physical activity and healthy food choices and to develop a community-based process and model protocol that achieves a sustained reduction in systolic blood pressure (SBP) among African American adults in Hattiesburg, Mississippi. This intervention is motivated by rates of hypertension, obesity, lack of physical activity, and cardiovascular disease among Mississippi African Americans that are among the highest in the nation, and by the community's desire to address this problem through collaborative community approaches.
Specific aims are: 1) to develop and assess community capacity to promote physical activity and healthy food choices, 2) to test treatment effects of a 6-month CBPR walking intervention on systolic blood pressure among all walking participants, and 3) to test the treatment effects of a sustained motivational enhancement via telephone on SBP. Capacity building is addressed through multiple strategies to enhance, over the life of the intervention, specific dimensions of capacity including participation, leadership, skills, resources, networks, critical reflection, and community power. A comprehensive process evaluation will capture evidence of enhanced community capacity through multiple tracking methods as well as qualitative feedback from all participant levels. The Intervention Phase consists of a 6-month CBPR walking intervention to lower systolic blood pressure, using a single group pre-post design and including the following components: social support provided by volunteer walking group leaders, motivational interviewing (Ml) by trained intervention staff, pedometer diary self-monitoring, and monthly education sessions. Participants will be randomized at six months into a 12-month Mi enhanced or non-enhanced maintenance group, with Mi-enhanced receiving four Ml telephone counseling sessions to encourage continued physical activity. Outcome measures will be evaluated at three- to 12-month intervals throughout intervention and maintenance phases. Individual, group and intervention level process measures will be evaluated at weekly to quarterly intervals. A successful intervention will have a sustainable infrastructure to continue addressing health disparities and demonstrate a reduction in blood pressure with public health implications for reducing cardiovascular disease morbidity and mortality.
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