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A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study.

Publication ,  Journal Article
Samuel-Hodge, CD; Ziya Gizlice, ; Allgood, SD; Bunton, AJ; Erskine, A; Leeman, J; Cykert, S
Published in: American Journal of Health Promotion : Ajhp
July 2022

To evaluate the implementation and effectiveness of the Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program, an adapted evidence-based cardiovascular disease risk reduction intervention delivered by Community Health Workers (CHW) to rural adults.Hybrid implementation-effectiveness study with a pre-post design.North Carolina Federally Qualified Health Center and local health department in a rural, medically underserved area.Participants (n = 255) included 87% Non-Hispanic Black with a mean age of 57 years; 84% had diagnosed hypertension, 55% had diabetes, and 65% had hypercholesterolemia.A CHW-delivered, low-intensity, 4-month behavioral lifestyle intervention promoting a southern-style Mediterranean dietary pattern and physical activity.We measured number and representativeness of participants reached and retained, intervention delivery fidelity, weight, blood pressure, and self-reported dietary and physical activity behaviors.Pre-post changes at 4 months were analyzed using paired t-tests.Study participants completed 90% of planned intervention contacts; 87% were retained. Intervention delivery fidelity measures showed participants receiving a mean of 3.5 counseling visits, 2.7 booster calls, and on average completing 1.7 modules, setting 1.8 goals, and receiving 1.3 referrals per visit. There were significant mean reductions in systolic (-2.5 mmHg, P < .05) and diastolic blood pressure (-2.1 mmHg, P < .01); the proportion of participants with systolic blood pressure <130 increased by 7 % points (P = .05), and diastolic pressure <80 by 9 percentage points (P < .01). Dietary behaviors improved significantly with average weekly servings of nuts increased by .5 serving (P < .0001), and fruits and vegetables by .8 daily serving (P < .0001). Physical activity also increased on average by 45 min./week (P < .001). Weight did not change significantly.The CHANGE program showed both implementation and program effectiveness and adds to the evidence supporting CHW-delivered lifestyle interventions to reduce CVD risk among rural, Non-Hispanic Black, and medically underserved populations.

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Published In

American Journal of Health Promotion : Ajhp

DOI

EISSN

2168-6602

ISSN

0890-1171

Publication Date

July 2022

Volume

36

Issue

6

Start / End Page

948 / 958

Related Subject Headings

  • Rural Population
  • Public Health
  • Middle Aged
  • Medically Underserved Area
  • Hypertension
  • Humans
  • Community Health Workers
  • Cardiovascular Diseases
  • Blood Pressure
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Samuel-Hodge, C. D., Ziya Gizlice, ., Allgood, S. D., Bunton, A. J., Erskine, A., Leeman, J., & Cykert, S. (2022). A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study. American Journal of Health Promotion : Ajhp, 36(6), 948–958. https://doi.org/10.1177/08901171221078272
Samuel-Hodge, Carmen D., Carmen D. Ziya Gizlice, Sallie D. Allgood, Audrina J. Bunton, Amber Erskine, Jennifer Leeman, and Samuel Cykert. “A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study.American Journal of Health Promotion : Ajhp 36, no. 6 (July 2022): 948–58. https://doi.org/10.1177/08901171221078272.
Samuel-Hodge CD, Ziya Gizlice, Allgood SD, Bunton AJ, Erskine A, Leeman J, et al. A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study. American Journal of Health Promotion : Ajhp. 2022 Jul;36(6):948–58.
Samuel-Hodge, Carmen D., et al. “A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study.American Journal of Health Promotion : Ajhp, vol. 36, no. 6, July 2022, pp. 948–58. Epmc, doi:10.1177/08901171221078272.
Samuel-Hodge CD, Ziya Gizlice, Allgood SD, Bunton AJ, Erskine A, Leeman J, Cykert S. A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study. American Journal of Health Promotion : Ajhp. 2022 Jul;36(6):948–958.
Journal cover image

Published In

American Journal of Health Promotion : Ajhp

DOI

EISSN

2168-6602

ISSN

0890-1171

Publication Date

July 2022

Volume

36

Issue

6

Start / End Page

948 / 958

Related Subject Headings

  • Rural Population
  • Public Health
  • Middle Aged
  • Medically Underserved Area
  • Hypertension
  • Humans
  • Community Health Workers
  • Cardiovascular Diseases
  • Blood Pressure
  • Adult