Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention

• Main Authors: Oppezzo, Marily, Knox, Mariah, Skan, Jordan, Chieng, Amy, Crouch, Maria, Aikens, Rachael C, Benowitz, Neal L, Schnellbaecher, Matthew, Prochaska, Judith J
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: eScholarship, University of California 2022
• Subjects: Biomedical and Clinical Sciences; Public Health; Clinical Sciences; Health Sciences; Nutrition and Dietetics; Obesity; Behavioral and Social Science; Nutrition; Prevention; American Indian or Alaska Native; Clinical Research; Cardiovascular; Clinical Trials and Supportive Activities; Arctic; Heart Disease; Management of diseases and conditions; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; 7.1 Individual care needs; Prevention of disease and conditions; and promotion of well-being; Stroke; Cardiovascular Diseases; Diet; Healthy; Female; Humans; Male; Medication Adherence; Telemedicine; telehealth; cardiovascular disease; Alaska Native; dietary intake; Toxicology; Indian; Norton Sound; Alaska
• Online Access: https://escholarship.org/uc/item/4cg4q4w5

IntroductionInnovations are needed for preventing cardiovascular disease (CVD) and for reaching diverse communities in remote regions. The current study reports on a telemedicine-delivered intervention promoting a traditional heart-healthy diet and medication adherence with Alaska Native men and women residing in the Norton Sound region of Alaska.MethodsParticipants were 299 men and women with high blood pressure or high cholesterol smoking daily who were randomized to receive telemedicine-delivered counseling and printed materials on diet and medication adherence or on smoking and physical activity. Intervention contacts were at baseline and 3-, 6-, and 12-months follow-up, with a final assessment at 18 months. Nutrition outcomes were the ratio of heart-healthy foods and traditional heart-healthy foods relative to all foods reported on a 34-item food frequency questionnaire. Recent and typical adherence for heart medications were self-reported.ResultsIntervention effects were significant for the heart-healthy foods ratio at 6 months only (p = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (p = 0.031). For recent and typical medication adherence, there were no significant group differences by time.DiscussionIn a remote region of Alaska, telemedicine proved feasible and acceptable for engaging Alaska Native men and women in counseling on CVD risk behaviors. The findings indicate that more touchpoints may be necessary to impart comprehensive lasting change in heart-healthy eating patterns. Medication adherence group differences were not significant; however, medication adherence was high overall.