The GoodNEWS Trial
(Genes, Nutrition, Exercise, Wellness, and Spiritual Growth)
Sponsored by UT Southwestern Medical Center Division of Community Health Sciences through funding by the National Heart, Lung, and Blood Institute (Grant # R01 HL087768)
Despite the overall improvement in the health of Americans during the past two decades, significant differences or “disparities” in health outcomes persist among racial and ethnic minorities, and those with lower socioeconomic status (SES). Minority group status and lower income are associated with shorter life expectancy and higher rates of cardiovascular disease (CVD), diabetes, stroke, and hypertension. New approaches are needed in high-risk communities for reducing the risk of CVD.
Lay Health Promoters (LHPs) have been proposed as a means for overcoming barriers by building on the informal lay helping systems that already exist in communities. “Natural helping” strategies can contribute to community-based health promotion and disease prevention, and are endorsed by the Center’s for Disease Control and Prevention (CDC) for eliminating health disparities. Faith-based organizations (FBOs) are another community resource for preventing disease in high-risk populations, since they frequently offer health education, screening and management of high blood pressure and diabetes, weight loss and smoking cessation programs, and nutritional guidance programs. Combining LHP and FBO principles with a community-based health maintenance strategy could reduce the CVD burden in high-risk communities.
The GoodNEWS Program has been active in Dallas, Texas congregations since 2002, and has been pilot tested in African-American congregations throughout South Dallas. The present study builds on the success of the existing GoodNEWS collaboration, by expanding the program’s community-based health maintenance component and connecting it more closely with the medical community. The GoodNEWS (Genes, Nutrition, Exercise, Wellness, and Spiritual Growth) Trial, was initiated in 2007 with the following aims:
Aim 1:
Assess the effect of a health promotion program combined with a maintenance intervention (GoodNEWS-I) in African-American congregations, on increasing levels of physical activity and dietary change compared to the health promotion program alone (GoodNEWS-PA).
Hypothesis:
At the end of 18 months, GoodNEWS-I participants will have significant increases from baseline in physical activity (7-day physical activity recall [PAR]) and dietary change (Diet History Questionnaire [DHQ]) compared to GoodNEWS-PA participants.
Aim 2:
Determine the effect of the health promotion program and maintenance intervention on modifiable cardiovascular risk factors (GoodNEWS-I) compared to the health promotion program alone (GoodNEWS-PA).
Hypothesis:
Changes in lipoprotein levels, blood pressure, and fasting glucose will be significantly improved among GoodNEWS-I participants compared to baseline and in comparison with the GoodNEWS-PA participants.
Aim 3:
Identify individual and group sociodemographic factors associated with increasing and decreasing levels of physical activity (as measured by the PAR) and dietary change (as measured by DHQ).
In order to determine the effectiveness of the GoodNEWS program, 10 newly-trained congregations will work independently for 18 months (GoodNEWS-PA) and 10 will work with the existing GoodNEWS Community of Churches (GoodNEWS-I) who have been working together since 2005, to examine whether the collaborative approach or the independent approach is more effective at reducing chronic disease risk factors. At the end of this period, all of the congregations will work together for an additional 18 months, to see if the results change or remain the same. This approach is called the GoodNEWS Trial because we are gathering evidence to see if it is possible to reduce or prevent disease, through combining faith and health in a collaborative way and supporting one another in creating healthy individuals, congregations, and communities. GoodNEWS is part of a collaborative, on-going, and permanent partnership dating back to 2002 for improving the way we live through faith and health collaboration.