Sustainability of a multiple rlsk factor intervention on cardiovascular disease in high-risk African American families

Crystal W. Cene, Lisa Yanek, Taryn F. Moy, David Levine, Lewis Becker, Diane M Becker

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the long-term effect of a community-based risk reduction intervention at five years after completion of a one-year randomized clinical trial and to determine the sustainability of the beneficial effects seen one year after the intervention. Methods: 30- to 59- year-old African American siblings of probands with premature coronary heart disease (CHD) were randomized for care of multiple CHD risk factors to either one year of community-based care (CBC) provided by a nurse practitioner/community health worker team or enhanced usual care (EUC). At five years, 307 (84.6%) of the siblings returned for reevaluation. Main Outcome Measures: Changes in and achievement of goal levels of low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure (SBP and DBP, respectively), and smoking cessation at five years. Results: No significant differences were seen between groups in mean LDL-C, SBP, and DBP or in the overall percentages achieving goal LDL-C, blood pressure, or smoking status. Changes after completion of the intervention suggest that the CBC group lost the beneficial effects for mean LDL-C and for percentage at goal LDL-C, while the EUC group continued to improve. CBC was associated with greater sustainability and less refractoriness of one-year results for LDL-C and blood pressure goals. Conclusions: Although no group differences were found in mean risk factor levels at five years, data indicate that CBC is both feasible and associated with earlier sustainability of positive risk factor changes compared with EUC.

Original languageEnglish (US)
Pages (from-to)169-175
Number of pages7
JournalEthnicity and Disease
Volume18
Issue number2
StatePublished - Mar 2008

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African Americans
LDL Cholesterol
Cardiovascular Diseases
Blood Pressure
Coronary Disease
Siblings
Nurse Practitioners
Smoking Cessation
Risk Reduction Behavior
Randomized Controlled Trials
Smoking
Outcome Assessment (Health Care)

Keywords

  • African Americans
  • Cardiovascular Disease
  • Community Participation
  • Hypertension
  • Prevention
  • Risk Factors
  • Sustainability

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Sustainability of a multiple rlsk factor intervention on cardiovascular disease in high-risk African American families",
abstract = "Objectives: To determine the long-term effect of a community-based risk reduction intervention at five years after completion of a one-year randomized clinical trial and to determine the sustainability of the beneficial effects seen one year after the intervention. Methods: 30- to 59- year-old African American siblings of probands with premature coronary heart disease (CHD) were randomized for care of multiple CHD risk factors to either one year of community-based care (CBC) provided by a nurse practitioner/community health worker team or enhanced usual care (EUC). At five years, 307 (84.6{\%}) of the siblings returned for reevaluation. Main Outcome Measures: Changes in and achievement of goal levels of low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure (SBP and DBP, respectively), and smoking cessation at five years. Results: No significant differences were seen between groups in mean LDL-C, SBP, and DBP or in the overall percentages achieving goal LDL-C, blood pressure, or smoking status. Changes after completion of the intervention suggest that the CBC group lost the beneficial effects for mean LDL-C and for percentage at goal LDL-C, while the EUC group continued to improve. CBC was associated with greater sustainability and less refractoriness of one-year results for LDL-C and blood pressure goals. Conclusions: Although no group differences were found in mean risk factor levels at five years, data indicate that CBC is both feasible and associated with earlier sustainability of positive risk factor changes compared with EUC.",
keywords = "African Americans, Cardiovascular Disease, Community Participation, Hypertension, Prevention, Risk Factors, Sustainability",
author = "Cene, {Crystal W.} and Lisa Yanek and Moy, {Taryn F.} and David Levine and Lewis Becker and Becker, {Diane M}",
year = "2008",
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volume = "18",
pages = "169--175",
journal = "Ethnicity and Disease",
issn = "1049-510X",
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TY - JOUR

T1 - Sustainability of a multiple rlsk factor intervention on cardiovascular disease in high-risk African American families

AU - Cene, Crystal W.

AU - Yanek, Lisa

AU - Moy, Taryn F.

AU - Levine, David

AU - Becker, Lewis

AU - Becker, Diane M

PY - 2008/3

Y1 - 2008/3

N2 - Objectives: To determine the long-term effect of a community-based risk reduction intervention at five years after completion of a one-year randomized clinical trial and to determine the sustainability of the beneficial effects seen one year after the intervention. Methods: 30- to 59- year-old African American siblings of probands with premature coronary heart disease (CHD) were randomized for care of multiple CHD risk factors to either one year of community-based care (CBC) provided by a nurse practitioner/community health worker team or enhanced usual care (EUC). At five years, 307 (84.6%) of the siblings returned for reevaluation. Main Outcome Measures: Changes in and achievement of goal levels of low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure (SBP and DBP, respectively), and smoking cessation at five years. Results: No significant differences were seen between groups in mean LDL-C, SBP, and DBP or in the overall percentages achieving goal LDL-C, blood pressure, or smoking status. Changes after completion of the intervention suggest that the CBC group lost the beneficial effects for mean LDL-C and for percentage at goal LDL-C, while the EUC group continued to improve. CBC was associated with greater sustainability and less refractoriness of one-year results for LDL-C and blood pressure goals. Conclusions: Although no group differences were found in mean risk factor levels at five years, data indicate that CBC is both feasible and associated with earlier sustainability of positive risk factor changes compared with EUC.

AB - Objectives: To determine the long-term effect of a community-based risk reduction intervention at five years after completion of a one-year randomized clinical trial and to determine the sustainability of the beneficial effects seen one year after the intervention. Methods: 30- to 59- year-old African American siblings of probands with premature coronary heart disease (CHD) were randomized for care of multiple CHD risk factors to either one year of community-based care (CBC) provided by a nurse practitioner/community health worker team or enhanced usual care (EUC). At five years, 307 (84.6%) of the siblings returned for reevaluation. Main Outcome Measures: Changes in and achievement of goal levels of low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure (SBP and DBP, respectively), and smoking cessation at five years. Results: No significant differences were seen between groups in mean LDL-C, SBP, and DBP or in the overall percentages achieving goal LDL-C, blood pressure, or smoking status. Changes after completion of the intervention suggest that the CBC group lost the beneficial effects for mean LDL-C and for percentage at goal LDL-C, while the EUC group continued to improve. CBC was associated with greater sustainability and less refractoriness of one-year results for LDL-C and blood pressure goals. Conclusions: Although no group differences were found in mean risk factor levels at five years, data indicate that CBC is both feasible and associated with earlier sustainability of positive risk factor changes compared with EUC.

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