Black men have the greatest burden of premature death and disability from hypertension (HTN) in the United States due to a low blood pressure (BP) control rate. Improving BP control leads to cardiovascular (CV) risk reduction and can be achieved through therapeutic lifestyle changes (TLC). Despite the proven efficacy of TLC in large clinical trials, TLC in community-based settings is largely untested in this population. CRC is a major cause of cancer death in black men, with a death rate that is 50% higher than in white men. Though some methods have been successful in increasing CRC screening rates in minority groups, few have a focus on increasing CRC screening rates among black men in a non-practice community -based setting. We will address the gaps in the literature by evaluating the effectiveness of two evidence-based interventions focused on BP reduction and CRC screening in black men. The target population is 480 black men aged >50 years with uncontrolled HTN (BP >135/85 mm Hg) and in need of CRC screening. We hypothesize that black men, aged >50 years randomized to a motivational interviewing (MINT) lifestyle interven-tion will have significantly lower BP compared to those randomized to the CRC patient navigation interven-tion at 6 months. Alternatively, black men randomized to the CRC intervention will have significantly higher CRC screening rates compared to those randomized to the MINT intervention at 6 months. Subjects in the MINT lifestyle intervention condition will attend 1 one-on-one counseling followed by 8 phone-based MINT sessions biweekly for the first 2 months then monthly for 4 months. Those in the CRC intervention will receive one inperson and two phone contacts with health navigators. The primary outcomes will be (1) within-patient change in systolic and diastolic BP from baseline to 6 months and (2) colorectal cancer screening rates as determined by colonoscopy or FIT report from the primary care provider at 6 months. BP will be assessed by an automated digital BP monitor meeting AHA guidelines. CRC screen-ings will be self-reported and verified by medical records and/or colonoscopy or FIT reports from providers. The long-term goal is a new nontraditional model of disseminating interventions for CV risk reduction and CRC prevention in black men.
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