Findings from The GoodNEWS (Genes, Nutrition, Exercise, Wellness and Spiritual Growth) Trial: Reducing CVD risk in African-American congregations

Background: Although cardiovascular diseases (CVD) are the leading cause of death among Americans, significant disparities persist in CVD prevalence, morbidity, and mortality based on race and ethnicity. While the National Institutes of Health (NIH) recognizes the value of lifestyle modifications for reducing CVD risk, few studies have examined risk factor reduction among the poor and ethnic minorities. Methods: The GoodNEWS Trial is a community-based participatory research (CBPR) CVD risk reduction cluster randomized trial among 18 African-American predominantly middle and low-income congregations participating in the GoodNEWS Lifestyle Enhancement Program. The trial is funded by the National Heart, Lung and Blood Institute (NHLBI, RO1 HL087768). Primary outcomes are level of physical activity (7-Day Physical Activity Recall (PAR)) and saturated fat intake (Diet History Questionnaire (DHQ)); secondary outcomes are BMI, LDL, HDL, HgA1c, and blood pressure. Data analysis includes bivariate and multinomial logistic regression, Student t-test, and Chi-square. Results: Participants (n=392; 18-70 years) have significantly higher levels of disease than national averages for African-American adults: heart disease (9.3%), diabetes (15.3%), high cholesterol (36.3%), and high blood pressure (47.5%). Most are overweight or obese (86%) and BMI is associated with diabetes (p=.01) and hypertension (p=.0001) co-morbidities. Although there were few significant differences between treatment and control participants at 18-months, treatment participants improved HDL (p=.005), caloric intake (p=.001), saturated fat intake (p=.001), and HgA1c (p=.04). Conclusions: A faith-health collaborative program successfully reduced CVD among a sample of African-American adults with higher than average levels of disease; implications of preliminary findings will be discussed.