دورية أكاديمية
Different Lifestyle Interventions in Adults From Underserved Communities: The FAMILIA Trial.
العنوان: | Different Lifestyle Interventions in Adults From Underserved Communities: The FAMILIA Trial. |
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المؤلفون: | Fernandez-Jimenez R; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain. Electronic address: https://twitter.com/rodrigo_fjez., Jaslow R; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Bansilal S; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Diaz-Munoz R; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Fatterpekar M; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Santana M; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Clarke-Littman A; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Latina J; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Soto AV; Mount Sinai Medical Center, Miami Beach, Florida., Hill CA; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Al-Kazaz M; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Samtani R; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Vedanthan R; Department of Population Health, NYU School of Medicine, New York, New York., Giannarelli C; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Kovacic JC; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Bagiella E; Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, New York., Kasarskis A; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Fayad ZA; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York., Fuster V; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain. Electronic address: valentin.fuster@mountsinai.org. |
المصدر: | Journal of the American College of Cardiology [J Am Coll Cardiol] 2020 Jan 07; Vol. 75 (1), pp. 42-56. Date of Electronic Publication: 2019 Nov 11. |
نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983- |
مواضيع طبية MeSH: | Risk Reduction Behavior*, Family/*ethnology , Health Promotion/*economics , Health Promotion/*methods , Independent Living/*economics , Vulnerable Populations/*ethnology, Adult ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Minority Groups |
مستخلص: | Background: The current trends of unhealthy lifestyle behaviors in underserved communities are disturbing. Thus, effective health promotion strategies constitute an unmet need. Objectives: The purpose of this study was to assess the impact of 2 different lifestyle interventions on parents/caregivers of children attending preschools in a socioeconomically disadvantaged community. Methods: The FAMILIA (Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health) study is a cluster-randomized trial involving 15 Head Start preschools in Harlem, New York. Schools, and their children's parents/caregivers, were randomized to receive either an "individual-focused" or "peer-to-peer-based" lifestyle intervention program for 12 months or control. The primary outcome was the change from baseline to 12 months in a composite health score related to blood pressure, exercise, weight, alimentation, and tobacco (Fuster-BEWAT Score [FBS]), ranging from 0 to 15 (ideal health = 15). To assess the sustainability of the intervention, this study evaluated the change of FBS at 24 months. Main pre-specified secondary outcomes included changes in FBS subcomponents and the effect of the knowledge of presence of atherosclerosis as assessed by bilateral carotid/femoral vascular ultrasound. Mixed-effects models were used to test for intervention effects. Results: A total of 635 parents/caregivers were enrolled: mean age 38 ± 11 years, 83% women, 57% Hispanic/Latino, 31% African American, and a baseline FBS of 9.3 ± 2.4 points. The mean within-group change in FBS from baseline to 12 months was ∼0.20 points in all groups, with no overall between-group differences. However, high-adherence participants to the intervention exhibited a greater change in FBS than their low-adherence counterparts: 0.30 points (95% confidence interval: 0.03 to 0.57; p = 0.027) versus 0.00 points (95% confidence interval: -0.43 to 0.43; p = 1.0), respectively. Furthermore, the knowledge by the participant of the presence of atherosclerosis significantly boosted the intervention effects. Similar results were sustained at 24 months. Conclusions: Although overall significant differences were not observed between intervention and control groups, the FAMILIA trial highlights that high adherence rates to lifestyle interventions may improve health outcomes. It also suggests a potential contributory role of the presentation of atherosclerosis pictures, providing helpful information to improve future lifestyle interventions in adults. (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.) |
التعليقات: | Comment in: J Am Coll Cardiol. 2020 Jan 7;75(1):57-59. (PMID: 31918834) |
فهرسة مساهمة: | Keywords: caregivers; health promotion; lifestyle; parents; vulnerable populations |
تواريخ الأحداث: | Date Created: 20191115 Date Completed: 20200805 Latest Revision: 20200805 |
رمز التحديث: | 20240628 |
DOI: | 10.1016/j.jacc.2019.10.021 |
PMID: | 31726193 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1558-3597 |
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DOI: | 10.1016/j.jacc.2019.10.021 |