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Wright KD, Klatt MD, Adams IR, Nguyen CM, Mion LC, Tan A, Monroe TB, Rose KM, Scharre DW. Mindfulness in Motion and Dietary Approaches to Stop Hypertension (DASH) in Hypertensive African Americans. J Am Geriatr Soc 2020; 69:773-778. [PMID: 33227157 DOI: 10.1111/jgs.16947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Hypertension increases the risk of developing Alzheimer's disease or related dementias. This pilot study's purpose was to examine the feasibility and acceptability of a novel intervention, Mindfulness in Motion (MIM) and Dietary Approaches to Stop Hypertension DASH (MIM DASH), to improve diet, mindfulness, stress, and systolic blood pressure (BP) in older African Americans with mild cognitive impairment (MCI) and hypertension. DESIGN Cluster randomized controlled trial. SETTING Intergenerational community center in a large metropolitan area. PARTICIPANTS African Americans with MCI and hypertension. Participants were divided into six groups randomized 1:1:1 to the MIM DASH group, attention only (non-hypertensive education) group, or true control group. The MIM DASH and attention only interventions were delivered in 8-weekly 2 hour group sessions. MIM included mindful movements from chair/standing, breathing exercises, and guided meditation. The DASH component used a critical thinking approach of problem solving, goal setting, reflection, and self-efficacy. The true control group received a DASH pamphlet at the end. MEASUREMENTS Feasibility was tracked through enrollment and attendance records; acceptability was assessed through interviews. Blood pressure was measured using the Omron HEM-907XL Monitor. Dietary intake was measured by DASH-Q. Mindfulness was measured by the Cognitive and Affective Mindfulness Scale. Stress was measured by the Perceived Stress Scale. MCI was determined using the Self-Administered Gerocognitive Examination. Data were collected at baseline and 3-months. RESULTS Median session attendance was six for the MIM DASH group and six for the attention only group. There were no changes in diet, mindfulness, or stress. There was a clinically significant reduction in systolic BP in the MIM DASH group (-7.2 mmHg) relative to the attention only group (-.7), and no change between the MIM DASH and true control groups. CONCLUSION Results indicate that the MIM DASH intervention was feasible and culturally acceptable in African Americans with hypertension and MCI.
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Affiliation(s)
- Kathy D Wright
- College of Nursing, Center of Excellence in Critical and Complex Care, The Ohio State University, Columbus, Ohio, USA
| | - Maryanna D Klatt
- Department of Family and Community Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Ingrid Richards Adams
- The Ohio State University College of Medicine, Columbus, Ohio, USA.,Health & Rehabilitation Sciences, Medical Dietetics, College of Food, Agricultural, and Environmental Sciences, Columbus, Ohio, USA
| | - Christopher M Nguyen
- The Ohio State University College of Medicine, Columbus, Ohio, USA.,Department of Psychiatry & Behavioral Health, Neurology, & Psychology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Lorraine C Mion
- College of Nursing, Center of Excellence in Critical and Complex Care, The Ohio State University, Columbus, Ohio, USA
| | - Alai Tan
- College of Nursing, Center of Excellence in Critical and Complex Care, The Ohio State University, Columbus, Ohio, USA
| | - Todd B Monroe
- College of Nursing, Center of Excellence in Critical and Complex Care, The Ohio State University, Columbus, Ohio, USA
| | - Karen M Rose
- College of Nursing, Center of Excellence in Critical and Complex Care, The Ohio State University, Columbus, Ohio, USA
| | - Douglas W Scharre
- The Ohio State University College of Medicine, Columbus, Ohio, USA.,Department of Neurology, Center for Cognitive and Memory Disorders, Center for Neuromodulation, Columbus, Ohio, USA
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Smith ED, Layden BT, Hassan C, Sanchez-Johnsen L. Surgical Treatment of Obesity in Latinos and African Americans: Future Directions and Recommendations to Reduce Disparities in Bariatric Surgery. Bariatr Surg Pract Patient Care 2018; 13:2-11. [PMID: 32612896 PMCID: PMC7325708 DOI: 10.1089/bari.2017.0037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction: Obesity and metabolic syndrome are increasingly prevalent in the United States, particularly among African Americans and Latinos. Bariatric surgery has become one of the primary treatment modalities for obesity and type 2 diabetes. However, fewer Latinos and African Americans are undergoing bariatric surgery than whites. The aim of this article is to describe the disparities in seeking and accessing bariatric surgery, describe the outcomes following bariatric procedures in Latinos and African Americans, and offer recommendations and future research directions that may assist in addressing these disparities. Methods: Original research and review articles published in English were reviewed. Results: Potential reasons why Latinos and African Americans have low rates of seeking bariatric surgery are described. Disparities in access to care and financial coverage, low rates of referral by primary care providers, and cultural attitudes toward obesity in conjunction with mistrust of the healthcare system are discussed as potential contributors to the low rate of bariatric surgery in Latinos and African Americans. Finally, disparities in bariatric surgery outcomes, comorbidities, and complications are reviewed. Conclusions: Additional research studies in bariatric surgical disparities are needed. Recommendations and future directions that may help to reduce disparities in bariatric surgery are discussed.
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Affiliation(s)
- Emily Daviau Smith
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.,Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois
| | - Brian T Layden
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.,Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois
| | - Chandra Hassan
- Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
| | - Lisa Sanchez-Johnsen
- Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.,Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
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Abstract
OBJECTIVE Little is known about diabetes status among US blacks by nativity. This study aims to measure differences in diabetes among US blacks by region of birth and examines potential explanations for subgroup differences. DESIGN Data from 47,751 blacks aged 25-74 pooled from the 2000-2013 waves of the National Health Interview Survey were analyzed. Logistic regression models predicted self-reported diabetes. The roles of education, income, body mass index (BMI), smoking, and duration of US residence were explored. RESULTS Compared to the US-born, foreign-born blacks had significantly lower reported diabetes prevalence (8.94% vs. 11.84%) and diabetes odds ratio [OR: 0.75; 95% confidence interval (CI): 0.62, 0.89], adjusting for socio-demographic characteristics. Further inclusion of education, income, household size, and smoking did not appreciably change the OR (0.77; 95% CI: 0.61, 0.86). Including an adjustment for BMI entirely eliminated the foreign-born advantage (OR 0.93; 95% CI: 0.78, 1.11). The foreign-born from the Caribbean/Americas had similar diabetes odds compared to the African-born. Among the foreign-born, an increased duration of US residence was associated with a higher diabetes odds, but these associations did not reach statistical significance (p > 0.05). CONCLUSION The healthy immigrant advantage extended to diabetes among US blacks, a finding that is explained by lower levels of overweight/obesity among the foreign-born compared to the US-born. Nonetheless, more than 71.4% of the foreign-born were overweight or obese. Understanding the mechanisms through which exposure to the US environment leads to higher obesity and diabetes risk may aid prevention efforts for the rapidly growing foreign-born black subpopulation.
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Affiliation(s)
- Nicole D. Ford
- Division of Biological and Biomedical Sciences,Emory University, 1518 Clifton Road, CNR 7000C, Atlanta, GA, USA 30033; ; phone: 404-395-4363; fax: 404-727-4590
| | - K.M. Venkat Narayan
- Division of Biological and Biomedical Sciences, Emory University, 1518 Clifton Road, CNR 7040, Atlanta, GA, USA 30033; ; phone: 404-727-8402
| | - Neil K. Mehta
- Hubert Department of Global Health, Emory University, 1518 Clifton Road, CNR 7035, Atlanta, GA, USA 30033; ; phone: 404-712-8812
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