This application addresses the development and translation of a medical technology to reduce health disparities within the priority area of chroni disease through the development and testing of an innovative web-based technology, Cookin'Up Health, for the self-management of diet related to hypertension and diabetes in African Americans. Delivered via primary care providers, the intervention addresses and responds to key barriers to adequate healthcare delivery-knowledge, culture, and infrastructure. There is a critical need for the development of effective, culturally appropriate, chronic disease focused dietary interventions that can be easily and quickly delivered by health care providers and readily used by African American patients. African Americans have disproportionately higher rates of diabetes and hypertension than the general population and are more likely to suffer the late-term debilitating consequences of these conditions. African Americans are particularly at risk for diet-related chronic diseases and complication because of obesity and unhealthy eating habits. A major barrier to making dietary changes is the high fat and salty foods found in traditional "southern cooking," which many African Americans in the South have eaten for most of their lives. Dietary habits are an important modifiable risk factor for hypertension and diabetes. Hypertension and diabetes are manageable diseases that require a both active medical management and self-management to control the disease. African Americans often have limited access to healthcare information needed for self-management. Nutritional and other lifestyle advice provided by clinicians has been declining over the last decade despite national recommendations for physicians to counsel all patients with diet-related chronic disease.Limited time spent with patients is the major barrier to nutrition counseling particularly given the many preventive recommendations and high volume of patients seen in most primary care practices. The proposed intervention consists of two integrated components-an interactive website and a series of individually tailored electronic newsletters. The website uses a cooking show theme to educate and demonstrate healthier versions of traditional recipes and provides food selection and preparation information in an easy-to-use, interactive, and culturally targeted format. A more limited version of Cookin'Up Health has already been shown to be effective in reducing dietary fat and increasing fruit and vegetable consumption among rural, low-literate, low-income women living in Appalachia. The proposed program will build on the work and outcomes of this earlier program, adapting it for a new population and expanding its reach.
For Aim 1, we will translate the Cookin'Up Health intervention to address the cultural and dietary characteristics and disease management needs of low- income African American patients with diabetes or hypertension.
For Aim 2, we will conduct a study to assess patient and provider usability and satisfaction with the translated intervention. If feasible with the priority populatin and providers, Phase II offers opportunity for expansion in scope and technology.
African Americans have disproportionately higher rates of diabetes and hypertension than the general population and are more likely to suffer the late-term debilitating consequences of these conditions, as well as shorter life expectancies. Dietary habits are an important modifiable risk factor for hypertension and diabetes. There is a critical need for the development of an effective, culturally appropriate, chronic disease focused dietary intervention that can be easily and quickly delivered by health care providers, and readily used by African American patients.