Evaluation of a community nutrition intervention to decrease hypertension risk

Abstract

Culturally appropriate interventions for decreasing dietary risk factors for hypertension are important in reducing morbidity and mortality. The purpose of the Hypertension Education Risk Reduction study was to evaluate a community-based nutrition intervention to decrease dietary risk factors for hypertension in a low-income population. This study evaluated whether a Health Belief Model-based curriculum was more effective than the standard curriculum used in the Expanded Food and Nutrition Education Program (EFNEP) in increasing consumption of fruits, vegetables, and milk group foods and in decreasing sodium using a quasi-experimental non-equivalent control group design. Participants (n=219) were primarily Black females who received some type of Federal assistance. The intervention curriculum consisted of six learner-centered sessions featuring experiential learning and active food experiences. The primary outcome variable was dietary intake, measured by 24-hour diet recalls at baseline and follow-up. Data were analyzed using NEERS5 software for dietary analysis and SPSS version 15 for statistical analysis. Behavioral constructs measured were perceived benefits of, barriers to, and self-efficacy for consuming a hypertension-protective diet.

Results of independent samples t-tests showed a statistically significant increase in vegetable intake in the intervention group receiving the Health Belief Model-based curriculum compared to the control group (standard curriculum). Intake of fruits and milk group foods increased and sodium decreased, but not significantly. In both groups, dietary intake of vegetables, fruits, and milk group foods was less than recommended by MyPyramid and the DASH diet. Positive trends toward increased self-efficacy and an increase in the perceived benefits of a hypertension-protective diet were observed, along with a decrease in perceived barriers.

Hypertension affects a disproportionate number of Black adults and diet is a major risk factor for this disease. Community nutrition education through EFNEP can play an important role in decreasing dietary risk factors for hypertension.