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What was the research about?

Compared with men of other races in the United States, black men are more likely to have long-term, or chronic, health problems such as high blood pressure or diabetes. These problems increase their chances of poor quality of life, stroke, and early death. Healthy behaviors, such as exercising and eating fruits and vegetables, can reduce the risk of chronic health problems.

In this study, the research team wanted to learn if a program called Active & Healthy Brotherhood, or AHB, designed for black men, would help them increase their daily exercise. The team compared men in AHB with men who received basic education on managing chronic health problems. The team also looked at how AHB affected other healthy behaviors and signs of health problems, such as high blood pressure and blood sugar.

What were the results?

After 6 and 12 months, black men who were in AHB and men who received only basic education didn’t differ in overall daily exercise. But compared with men who had basic education, men in AHB had

• Larger decreases in blood pressure and sugar after 6 months
• Larger increases in steps per day after 12 months
• Larger decreases in daily calories from saturated fat and total fat at 12 months

The two groups didn’t differ in

• Time spent being inactive per day
• Body fat, blood cholesterol, and how well their kidneys worked
• Healthcare visits and how well they followed their medicine plans
• Stress management
• Quality of life

Who was in the study?

The study included 333 black men from four counties in North Carolina. Men in the study didn’t exercise often or eat enough fruits and vegetables, or they had diabetes, high blood pressure, or heart disease. The average age was 51.

What did the research team do?

The research team assigned men in the study by chance to one of the two groups. The AHB group received 1 basic education session and then 16 weekly sessions. The sessions focused on being active, eating healthy, and managing stress. They included small-group activities for the men to discuss health goals and support each other. After AHB ended, the men received three phone calls to talk about goals and ways to achieve them. The second group received the basic education session and information about improving healthy behaviors.

Men in the study wore fitness trackers. The trackers measured daily exercise, time spent being inactive, and walking. The men completed surveys about healthy behaviors at the start of the study and at follow-up visits 6 and 12 months later.

Black men served as members of the research team and provided feedback throughout the study.

What were the limits of the study?

Fewer men joined the study than the research team expected. Also, 25 percent of men in the AHB program didn’t attend any weekly sessions. These factors limited the team’s ability to see differences between AHB and basic education.

Future research could continue to look for ways to help black men improve their health and could explore better ways to engage black men in these studies.

How can people use the results?

Health educators can use these results when considering ways to help black men improve their health.

Objective

To compare the effectiveness of a culturally tailored healthy lifestyle program with education on chronic disease management in improving daily physical activity, other healthy behaviors, and health-related outcomes among African-American men with or at high risk for chronic diseases

Study Design

Compared with men of other races in the United States, African-American men have disproportionately higher rates of chronic disease. This randomized controlled trial assessed the effectiveness of a culturally tailored healthy lifestyle program called Active & Healthy Brotherhood (AHB) for managing and reducing the risk for chronic diseases among African-American men. In a prior pilot study, the research team tailored AHB to address stressors associated with living up to gender-role norms and barriers African-American men face to being active, eating healthy, and managing stress.

In this study, the research team randomly assigned participants to AHB or to the education-only group. AHB included a basic health education session and 16 weekly sessions on building self-efficacy for healthy lifestyle skills. Sessions included small-group exercises to enhance social support and accountability for healthy lifestyle goals. After AHB, participants received three phone calls to review progress, identify barriers to healthy behaviors and solutions, recognize successes, and adjust goals. The education-only group received the basic health education session and information about improving healthy behaviors.

The study included 333 African-American men from four counties in North Carolina. Study participants were not meeting guidelines for physical activity or fruit and vegetable intake or had diabetes, hypertension, or cardiovascular disease. The average age was 51.

Study participants wore fitness trackers to measure daily physical activity, sedentary behavior, and daily walking. They also completed assessments on health-related outcomes at the beginning of the study and again at follow-up assessments 6 and 12 months later.

African-American men served as members of the research team, helped design AHB, and provided feedback throughout the study.

Results

After 6 and 12 months, participants in AHB and those men in the education-only group did not differ significantly in overall daily physical activity.

After six months, participants in AHB had larger decreases in blood pressure, hemoglobin A1c and glucose levels (all p<0.05), after adjusting for baseline values and age. These differences were not maintained at 12-month follow-up. After 12 months, participants in AHB had larger increases in steps per day and larger decreases in daily calories from saturated fat and total fat (all p<0.05), after adjusting for baseline values and age. The two groups did not differ significantly in any other secondary outcomes at either timepoint.

Limitations

The study did not reach its recruitment goal of 400 participants; 25% of participants assigned to AHB did not attend any sessions. These factors limited the study’s ability to detect effects from AHB.

Conclusions and Relevance

Although overall daily physical activity did not improve, African-American men in AHB had larger improvements in steps per day and nutrition-related outcomes compared with those men who received only education on chronic disease management.

Future Research Needs

Future research could continue to investigate ways to manage and reduce risk for chronic diseases among African-American men and to better engage African-American men as participants in clinical research studies.