Abstract
Participant adherence is a major threat to intervention effectiveness. Most researchers have reported effects of a single adherence measure on health outcomes. The objective of this analysis was to evaluate two adherence measures, separately and in combination, for predicting changes in health outcomes using data from a community‐based lifestyle intervention, HUB City Steps, conducted in a southern, African American population. Data were collected in 2010 from 269 participants in this 6‐month intervention targeting lifestyle changes to reduce blood pressure (BP). Two measures, education session attendance (ESA) and weekly steps/day pedometer diary submission (PDS) were used to create adherence indicators. Changes in anthropometric (body mass index, waist circumference, percent body fat, fat mass) and clinical (BP, lipids, glucose) outcomes were assessed. Based on bivariate tests, associations were observed between adherence indicators and several health outcome changes (r = −0.3 to −0.2; P < 0.05). After controlling for baseline covariates using multivariable linear regression, not all of these bivariate relationships remained significant. For BP, a 1unit increase in the ESA/PDS continuous indicator resulted in a 0.3 mm Hg decrease. Adherence to intervention components may differentially predict changes in health outcomes. Funding: National Institute for Minority Health and Health Disparities.
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