Background Native Hawaiians have higher hypertension (HTN) and cardiovascular disease (CVD) rates than non-Hispanic whites, calling for culturally responsive interventions to close this gap. Purpose We tested the effects of a 6-month behavioral intervention, a cultural dance program based on hula (the customary dance of Hawai'i), for improving blood pressure (BP) and CVD risk among Native Hawaiians with uncontrolled HTN. Methods In a randomized controlled trial, we tested the effects of the hula-based intervention among 263 Native Hawaiians with uncontrolled HTN (systolic ≥ 140 or ≥ 130 mmHg if diabetes) and no CVD at enrollment. All participants received a brief culturally tailored heart health education before random assignment to the hula-based intervention (n = 131) or the education-only waitlist control (n = 132). Intervention received hula lessons and group-based activities for 6 months. Control received only 1-week education through 6 months. Results Intervention yielded greater reductions in systolic (−15.3 mmHg) and diastolic (−6.4 mmHg) BP than control (−11.8 and −2.6 mmHg, respectively) from baseline to 6 months (p < .05). At 6 months, 43% of intervention participants compared to 21% of controls achieved a HTN stage <130/80 mmHg (p < .001). The 10-year CVD risk reduction was two times greater for the intervention group than the control group based on the Framingham Risk Score calculator. All improvements for intervention participants were maintained at 12 months. Conclusions This trial represents one of the few rigorously conducted examinations of an Indigenous practice leveraged for health promotion, with implications for other ethnic populations.

中文翻译：

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文化舞蹈项目可改善夏威夷原住民的高血压控制和心血管疾病风险：随机对照试验


背景 夏威夷原住民的高血压 (HTN) 和心血管疾病 (CVD) 发病率高于非西班牙裔白人，呼吁采取文化响应型干预措施来缩小这一差距。目的 我们测试了为期 6 个月的行为干预（一种基于草裙舞（夏威夷的传统舞蹈）的文化舞蹈项目）对于改善高血压 (HTN) 不受控制的夏威夷原住民的血压 (BP) 和 CVD 风险的效果。方法 在一项随机对照试验中，我们在 263 名未受控制的 HTN（收缩压 ≥ 140 或 ≥ 130 mmHg，如果是糖尿病）且入组时没有 CVD 的夏威夷原住民中测试了草裙舞干预的效果。所有参与者都接受了简短的根据文化定制的心脏健康教育，然后随机分配到草裙舞干预组 (n = 131) 或纯教育候补对照组 (n = 132)。干预接受了为期 6 个月的草裙舞课程和小组活动。对照组在 6 个月内仅接受了 1 周的教育。结果 6 个月期间，干预措施使收缩压 (-15.3 mmHg) 和舒张压 (-6.4 mmHg) 血压比对照组（分别为 -11.8 和 -2.6 mmHg）下降幅度更大 (p < .05)。 6 个月时，43% 的干预参与者达到 HTN 阶段 <130/80 mmHg (p < .001)，而对照组为 21%。根据弗雷明汉风险评分计算器，干预组 10 年 CVD 风险降低幅度是对照组的两倍。干预参与者的所有改善均维持在 12 个月。结论 这项试验是对用于健康促进的土著实践进行的少数严格检查之一，对其他种族人群也有影响。