A culturally adapted telecommunication system to improve physical activity, diet quality, and medication adherence among hypertensive African-Americans: a randomized controlled trial
Open accessAbstract
BACKGROUND: Hypertension is more prevalent and clinically severe among African-Americans than whites. Several health behaviors influence blood pressure (BP) control, but effective, accessible, culturally sensitive interventions that target multiple behaviors are lacking. PURPOSE: We evaluated a culturally adapted, automated telephone system to help hypertensive, urban African-American adults improve their adherence to their antihypertensive medication regimen and to evidence-based guidelines for dietary behavior and physical activity. METHODS: We randomized 337 hypertensive primary care patients to an 8-month automated, multi-behavior intervention or to an education-only control. Medication adherence, diet, physical activity, and BP were assessed at baseline and every 4 months for 1 year. Data were analyzed using longitudinal modeling. RESULTS: The intervention was associated with improvements in a measure of overall diet quality (+3.5 points, p < 0.03) and in energy expenditure (+80 kcal/day, p < 0.03). A decrease in systolic BP between groups was not statistically significant (-2.3 mmHg, p = 0.25). CONCLUSIONS: Given their convenience, scalability, and ability to deliver tailored messages, automated telecommunications systems can promote self-management of diet and energy balance in urban African-Americans.
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- Authors
- Migneault, J. P., Dedier, J. J., Wright, J. A., Heeren, T., Campbell, M. K., Morisky, D. E., Rudd, P., & Friedman, R. H.
- Affiliations
- Boston University (US)
- University of Massachusetts Boston (US)
- University of North Carolina at Chapel Hill (US)
- Stanford Medicine (US)
- Corresponding author
- Dedier, Julien J.
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-01-14
- Volume
- 43
- Issue
- 1
- Pages
- 62-73
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC8996679
- OpenAlex
- W1968356480
- Semantic Scholar
- eef571616ee1a0e4ae83241ef5252bcde633cf68
- Cited by
- 101
- References
- 37
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 10 · 2023: 12 · 2022: 9 · 2021: 8 · 2020: 6 · 2019: 9 · 2018: 5 · 2017: 12 · 2016: 3 · 2015: 9 · 2014: 8 · 2013: 4 · 2012: 1
- FWCI
- 12.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute ((R01 HL69395, R01HL069395)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- hypertension, African Americans, culturally tailored interventions, medication adherence, diet quality, physical activity, blood pressure control, energy expenditure, self-management, health behavior change
- MeSH terms
- Adult, Aged, Behavior Therapy, Black or African American, Culture, Diet, Female, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Patient Compliance, Self Care, Telephone, Health Behavior, Case-Control Studies, Telemedicine, Medication Adherence
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