Introduction
Methods
Performance Sites
Study lead sites | |||
---|---|---|---|
ABC | The Imperative | RCSHD | UC Davis |
Participating partner community and faith-based sites | |||
Baltimore, MD: Transformation Ministries of UCJC | Turner Chapel AME Church; Marietta, GA | Seattle, WA: St. Andrew Kim Church | Eastern Shore, NY |
Sigma Mu Zeta–(Zeta Phi Beta); Marietta, GA | |||
Yemassee, SC: Family Worship Center (Apostolic) | Center for Black Women’s Wellness; Atlanta, GA | Lodge Grass, MT: Our Lady of Loretto Church | Fresno, CA |
Atlanta Chapter Mocha Mom; Atlanta, GA | |||
Lakeland, FL: Greater Faith Christian Center, 1st Pentecostal Apostolic Church, Inc | New Covenant AME Church; Charlotte, NC | Carthage, MO: Grace Episcopal Church | Phoenix, AZ |
Yonkers, NY: United Church of Jesus Christ | Delta Zeta (Zeta Phi Beta); Charlotte, NC | Detroit, MI: Most Holy Redeemer | Prince Georges County, MD |
Spring Lake, NC: The Soul Harvest Apostolic Church | Chicago Chapter, Mocha Moms; Chicago, IL | St. Louis, MO: Centennial Christian Church | Sacramento, CA |
Tau Xi Zeta (Zeta Phi Beta); Chicago, IL | |||
Decatur, GA: Kingdom Building Worship Ministries | Mt. Calvary AME; Towson, MD | Buffalo, NY: Mt. Olive Baptist Church | Selma, AL |
Orange, NJ: 1st United Tabernacle Church | Lambda Pi Zeta (Zeta Phi Beta); Carson, CA | Atlanta, GA: Atlanta Intercultural Ministries, Inc. | Shelby County, TN |
Auxiliary: Carson Zeta Amicae (Zeta Phi Beta); Carson, CA | |||
Grant AME Church; Los Angeles, CA | |||
Randallstown, MD: Set the Captives Free | AME Union Church; Philadelphia, PA | Ypsilanti, MI: Brown Chapel A.M.E. Church | Windy City, IL |
Columbia, SC: Rehoboth United Apostolic | Philadelphia Chapter, Mocha Moms | Cleveland, OH: La Sagrada Familia | – |
Gwynn Oak, MD: Mount Olive Holy Evangelical | Beta Delta Zeta; Philadelphia, PA | – | – |
Participants and Recruitment
Program Implementation and Study Design
Outcome Variables and Metrics
Primary outcome measures |
Decrease the proportion of women who are obese (BMI> = 30 kg/m2) |
Increase the proportion of women who engage regularly (at least 30 min/day) in moderate physical activity (outside of program sessions) |
Secondary outcome measures |
Decrease the proportion of women who smoke cigarettes |
Increase the proportion of women with diabetes at baseline whose diabetes is under control (FBS<=125 mg/dl) |
Increase the proportion of women with high blood pressure at baseline whose blood pressure is under control (SBP<=140 mmHg, DBP<=90 mmHg); (SBP<=120 mmHg, DBP<=80 mmHg) |
Decrease the proportion of women with high total blood cholesterol (>240 mmHg; >200 mmHg) |
Increase the proportion of women who are aware that heart disease is the #1 killer of women |
Increase the proportion of women who are aware of the early warning symptoms and signs of a heart attack and the importance of accessing rapid emergency care by calling 911 |
Increase the proportion of women who know all of the major risk factors for CVD (overweight, physical inactivity, smoking, diabetes, blood pressure, cholesterol) |
Increase the proportion of women who know how to modify the major risk factors for CVD (overweight, physical inactivity, smoking, diabetes, blood pressure, cholesterol) |
For each CVD clinical risk factor (overweight, physical inactivity, smoking, diabetes, blood pressure, cholesterol), move 50% of women forward at least one Stage of Change |
Data Coordinating Center, Data Management, and Data Analysis
Results
Participant Flow and Characteristics
Characteristic | Lead study site | ||||
---|---|---|---|---|---|
Total cohort, % enrollees | ABC | The Imperative | RCSHD | UC Davis | |
Demographics, no. | (n = 1,052) | 254 (24%) | 226 (21.5%) | 246 (23.4%) | 326 (29.9%) |
Age, years | |||||
<40 | 13.1 | 22.4 | 19.9 | 12.2 | 8.6 |
40–60 | 51.4 | 42.4 | 54.4 | 60.2 | 50.5 |
>60 | 25.5 | 18.4 | 19.9 | 28.3 | 33.6 |
Race | |||||
Caucasian (non-Hispanic) | 3.8 | 0.3 | 0.0 | 15.2 | 0.3 |
Black (non-Hispanic) | 72.7 | 75.7 | 90.7 | 30.9 | 92.1 |
Asian/Pacific Islander | 1.9 | 0.3 | 0.0 | 7.8 | 0.0 |
American Indians/Alaska natives | 2.7 | 1.3 | 0.4 | 9.3 | 0.0 |
Other | 6.9 | 0.7 | 0.4 | 26.8 | 0.0 |
Unknown/Missing | 11.6 | 21.4 | 8.0 | 10.0 | 6.4 |
Ethnicity | |||||
Hispanic | 14.7 | 4.3 | 3.9 | 46.4 | 1.0 |
Non-Hispanic | 84.0 | 91.4 | 94.4 | 53.2 | 96.9 |
Education | |||||
Some high school or less | 8.9 | 8.2 | 1.8 | 21.6 | 4.0 |
High school graduate | 10.5 | 11.8 | 8.3 | 16.7 | 4.9 |
Some college, vocational, or technical school | 23.2 | 28.6 | 24.8 | 22.7 | 17.4 |
College graduate | 21.1 | 15.8 | 26.1 | 15.6 | 27.0 |
Post-graduate | 22.2 | 9.9 | 28.3 | 11.5 | 38.2 |
Unknown/missing | 13.8 | 25.0 | 9.73 | 10.8 | 7.3 |
Health insurance status | |||||
Medicaid or state | 6.2 | 7.6 | 4.0 | 8.9 | 4.3 |
Medicare | 14.7 | 14.1 | 11.1 | 16.7 | 15.9 |
HMO or other commercial | 49.0 | 36.2 | 62.0 | 33.5 | 64.8 |
Disability | 1.6 | 2.3 | 1.8 | 1.1 | 1.2 |
Private pay | 9.2 | 8.2 | 7.1 | 8.6 | 12.2 |
None | 12.4 | 12.2 | 10.2 | 26.8 | 2.5 |
Other | 6.7 | 4.9 | 7.1 | 9.7 | 5.5 |
Unknown/missing | 1.2 | 2.6 | 0.4 | 1.5 | 0.0 |
Socioeconomic status (income/year) | |||||
Up to $19,999 | 9.9 | 10.2 | 7.5 | 20.8 | 2.5 |
$20,000–39,999 | 16.1 | 18.8 | 16.4 | 20.8 | 9.5 |
$40,000–74,999 | 21.7 | 18.8 | 25.7 | 17.1 | 25.4 |
≥$75,000 | 21.7 | 10.5 | 27.9 | 6.7 | 40.1 |
Unknown/missing | 21.9 | 34.9 | 13.3 | 23.4 | 14.4 |
Characteristic (risk variable) | Baseline (n = 1052) |
---|---|
% Enrollees | |
Diabetes mellitus (self-report) | 15.5 |
Pre-diabetes | 17.7 |
FBS ≥ 126 mg/dl | 8.7 |
Hypertension (self report) | 42.0 |
SBP ≥ 140 or DBP ≥ 90, mmHg | 33.8 |
SBP ≥ 120 or DBP ≥ 80, mmHg | 73.2 |
Pre-hypertensive (self-report) | 20.4 |
Prescribed medication for HBP (self-report) | 40.9 |
Hypercholesterolemia | |
TC > 240 mg/dl | 5.8 |
TC > 200 mg/dl | 25.3 |
Obesity | |
BMI ≥ 30 kg/m2
| 38.4 |
Mean BMI (kg/m2) | 32.2 |
Physical activity (self-report)—days/week | |
≤2 days | 30.6 |
3–4 days | 24.7 |
≥5 days | 28.6 |
Smoking (self-report) | |
Everyday | 4.0 |
Some days | 1.5 |
Family History (self-report; early onset CVD in mother, sister, brother, or father) | 40.5 |
Heart disease (self-report) | |
CHF | 2.6 |
CAD | 3.0 |
Myocardial Infarction | 2.8 |
Angina | 3.8 |
Stroke (self report) | 2.5 |
Effect of the Intervention on Knowledge and Awareness of Heart Disease, Symptoms, and Taking Action
Women with follow-up | Women without follow-up | Missing at follow-up (%) | |
---|---|---|---|
Knowledge and awareness | |||
#1 Killer | 423 | 614 | 59.2 |
All symptoms MI | 265 | 772 | 74.4 |
Call 911 | 395 | 642 | 61.9 |
911 and all symptoms MI | 241 | 796 | 76.8 |
All CVD risk factors | 332 | 705 | 68.0 |
Risk factor control | |||
DM control | 396 | 641 | 61.8 |
HTN control (<140/90) | 219 | 818 | 78.9 |
HTN control (<120/80) | 219 | 818 | 78.9 |
Obesity control | 397 | 640 | 61.7 |
Physical activity | 461 | 576 | 55.5 |
Smoking control | 94 | 943 | 90.9 |
Cholesterol (>240) | 388 | 649 | 62.6 |
Cholesterol (>200) | 388 | 649 | 62.6 |
Risk factor knowledge | |||
HTN | 386 | 651 | 62.8 |
DM | 419 | 618 | 59.6 |
Smoking | 356 | 681 | 65.7 |
Cholesterol | 416 | 621 | 59.9 |
Physical activity | 403 | 634 | 61.1 |
Obesity | 422 | 615 | 59.3 |