Heart-Healthy Lenoir Lifestyle Study
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss, Peripheral Vascular Disease |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/22/2017 |
| Start Date: | September 2011 |
| End Date: | October 2014 |
Community-Based Lifestyle Intervention to Reduce CVD Risk & Disparities in Risk
This study aims to reduce cardiovascular disease (CVD) risk and disparities in risk by
improving lifestyle factors which underlie the development of CVD. The first steps will
involve conducting a comprehensive formative evaluation to assess individual, interpersonal,
organizational, community, and policy factors relevant to CVD risk and risk reduction in
Lenoir County. This will be followed by a community-based lifestyle intervention program
designed to improve eating patterns, promote physical activity, and for those who are
interested, support weight loss. A randomized trial comparing the effectiveness of two
community based weight maintenance interventions will also be conducted. Community-wide
policy and environmental change interventions will also be implemented to support the
individual-level interventions, including partnerships with businesses to promote a healthy
environment through innovative economic opportunities. In addition, this project will explore
genetic factors associated with cardiovascular disease risk and treatment success.
improving lifestyle factors which underlie the development of CVD. The first steps will
involve conducting a comprehensive formative evaluation to assess individual, interpersonal,
organizational, community, and policy factors relevant to CVD risk and risk reduction in
Lenoir County. This will be followed by a community-based lifestyle intervention program
designed to improve eating patterns, promote physical activity, and for those who are
interested, support weight loss. A randomized trial comparing the effectiveness of two
community based weight maintenance interventions will also be conducted. Community-wide
policy and environmental change interventions will also be implemented to support the
individual-level interventions, including partnerships with businesses to promote a healthy
environment through innovative economic opportunities. In addition, this project will explore
genetic factors associated with cardiovascular disease risk and treatment success.
The lifestyle intervention will enroll 350 participants. The initial lifestyle component of
this study, which lasts for 4-6 months, will be provided to all participants. Participants
may chose from one of two intervention formats, each with 4 contacts: individual counseling
with at least one face-to-face visit and the rest face-to-face or by phone or 4 group
sessions. The dietary intervention will focus on improving fat and carbohydrate quality. For
fat intake, the goals include 2-4 servings per day of polyunsaturated fat primarily from
plant sources and minimal intake of trans fat. For carbohydrate intake, the goals include
increased intake of whole grains, fruits and vegetables, and beans and reduced consumption of
refined carbohydrates. The physical activity intervention will primarily focus on walking
with a goal of 7500 to 10,000 steps per day or, for those who do not wish to use a pedometer,
30 minutes of walking a day. Muscle strengthening activities will also be recommended. At the
4-6 month follow-up measures, those who wish to take part in a weight loss study may do so
and those who do not will continue in a maintenance of lifestyle intervention.
The investigators anticipate approximately 200 participants will take part in the weight loss
component of this study, which consists of a 6 month intensive weight loss intervention.
Participants may choose from two intervention formats: 16 weekly group sessions or 5 group
sessions and 10 phone counseling sessions. The weight loss goal will be 5% of body weight. At
the conclusion of this program, those who lose at least 8 pounds and are willing to take part
in a 1 year maintenance of weight loss intervention will be RANDOMIZED to one of two
maintenance of weight loss programs. One maintenance arm will receive monthly telephone
contacts for one year, while the other arm will receive bi-monthly phone contacts.
Follow-up measures for all participants will be at approximately 6, 12, 18, and 24 months.
Another related part of the project will use a systems approach to develop models integrating
clinical and genomic data. Researchers have developed and tested an approach referred to as
the SAMARA (Supporting A Multidisciplinary Approach to Research in Atherosclerosis) Project
that applies recent, major advances in biomedical and computational sciences at UNC to
develop a deeper understanding of human CVD. The Heart-Healthy Lenoir Project will expand
studies into the community, using this methodology to: 1) determine the prevalence of genomic
risk signatures in high-risk community populations using genome-wide Single Nucleotide
Polymorphism (SNP) analysis; 2) develop novel genomic models incorporating high-risk features
in this population; and 3) determine whether genomic signatures can be used to predict
responsiveness to interventions that underlie CVD disparities. Participants who consent to
this component of the project will have a blood specimen obtained at baseline.
this study, which lasts for 4-6 months, will be provided to all participants. Participants
may chose from one of two intervention formats, each with 4 contacts: individual counseling
with at least one face-to-face visit and the rest face-to-face or by phone or 4 group
sessions. The dietary intervention will focus on improving fat and carbohydrate quality. For
fat intake, the goals include 2-4 servings per day of polyunsaturated fat primarily from
plant sources and minimal intake of trans fat. For carbohydrate intake, the goals include
increased intake of whole grains, fruits and vegetables, and beans and reduced consumption of
refined carbohydrates. The physical activity intervention will primarily focus on walking
with a goal of 7500 to 10,000 steps per day or, for those who do not wish to use a pedometer,
30 minutes of walking a day. Muscle strengthening activities will also be recommended. At the
4-6 month follow-up measures, those who wish to take part in a weight loss study may do so
and those who do not will continue in a maintenance of lifestyle intervention.
The investigators anticipate approximately 200 participants will take part in the weight loss
component of this study, which consists of a 6 month intensive weight loss intervention.
Participants may choose from two intervention formats: 16 weekly group sessions or 5 group
sessions and 10 phone counseling sessions. The weight loss goal will be 5% of body weight. At
the conclusion of this program, those who lose at least 8 pounds and are willing to take part
in a 1 year maintenance of weight loss intervention will be RANDOMIZED to one of two
maintenance of weight loss programs. One maintenance arm will receive monthly telephone
contacts for one year, while the other arm will receive bi-monthly phone contacts.
Follow-up measures for all participants will be at approximately 6, 12, 18, and 24 months.
Another related part of the project will use a systems approach to develop models integrating
clinical and genomic data. Researchers have developed and tested an approach referred to as
the SAMARA (Supporting A Multidisciplinary Approach to Research in Atherosclerosis) Project
that applies recent, major advances in biomedical and computational sciences at UNC to
develop a deeper understanding of human CVD. The Heart-Healthy Lenoir Project will expand
studies into the community, using this methodology to: 1) determine the prevalence of genomic
risk signatures in high-risk community populations using genome-wide Single Nucleotide
Polymorphism (SNP) analysis; 2) develop novel genomic models incorporating high-risk features
in this population; and 3) determine whether genomic signatures can be used to predict
responsiveness to interventions that underlie CVD disparities. Participants who consent to
this component of the project will have a blood specimen obtained at baseline.
Inclusion Criteria:
1. 18 years or older
2. live in Lenoir County or a neighboring county in Eastern North Carolina
3. anyone enrolled in the Lifestyle study is eligible to participate in the genomics
component of the project.
Exclusion Criteria:
1. non-English speaking
2. treatment of psychosis
3. alcohol or substance abuse within the two last years
4. history of malignancy, other than non-melanoma skin cancer, unless surgically cured >
5 years ago or in remission/well treated and not likely to have a negative effect on
the patient's health over the next 2 years
5. estimated creatinine clearance less than 30 ml/min
6. lack of access to phone
7. advanced dementia
8. participants who have been diagnosed with a myocardial infarction within the past
three months will be excluded from the study if they are unable to obtain written
medical clearance from their clinician to participate in the study
Additional Exclusion Criteria - Weight Loss Intervention:
1. the investigators will not invite pregnant women to take part in the weight loss
study.
2. if a woman becomes pregnant while taking part in this part of the study, we will
withdraw her from the weight loss study and invite her to continue in the lifestyle
study.
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