Cardiovascular (CV) disease remains the leading cause of death in this country and the City of Boston, (ref) Of concern, there is compelling evidence that a disproportionate share of the burden of CV disease, and metabolic/vascular risk factors falls on racial and ethnic minorities. [1] [3, 4] Eliminating these disparities is a national and local health priority;and adequate access to culturally appropriate, clinically effective preventive cardiovascular services is important to achieve this goal, (ref) The trend for individuals to have multiple risk factors is increasing[5] and although weight loss and lifestyle interventions have been shown to modify metabolic/vascular abnormalities and CVD risk factors, [3] [6-8] prevalence estimates of these conditions continue to increase, particularly for African Americans.[5] The barriers to effective risk factor reduction are multifactorial, including individual biopsychosocial and environmental factors.[9, 10] The high prevalence of African Americans with known multiple risk factors for CAD, the evidence that modifying risk factors can prevent or modify these conditions and the fact that barriers to effective risk factor reduction are multifactorial, suggests that prevention and risk factor reduction efforts should focus on comprehensive risk reduction strategies in this at-risk group. [5] Our team will test the feasibility of conducting a randomized, non-blinded,'parallel-group, study to assess the outcome of a community based, multiple risk factor diabetes prevention program in an at-risk African American community (Roxbury). The primary aims of the study are to demonstrate the feasibility of recruiting and retaining African American adults to this randomized trial and to describe changes in weight and waist circumference as well as behavioral, psychosocial and physiological endpbints. Recruitment in randomized clinical trials can be difficult in the African American community because of mistrust. This trial arises from several years of community partnership in the community of interest and builds on the trust established in this clinical work. In addition, little is known about the effectiveness, in underserved communities, of communitybased, culturally appropriate, multiple risk reduction interventions. Successful implementation of a community based multiple risk factor reduction program in this underserved and at-risk community has implications for practice and policy.
Showing the most recent 10 out of 16 publications
