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

Marily Oppezzo, Mariah Knox, Jordan Skan, Amy Chieng, Maria Crouch, Rachael C. Aikens, Neal L. Benowitz, Matthew Schnellbaecher and Judith J. Prochaska ()
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Marily Oppezzo: Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA
Mariah Knox: Cardiology Department, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
Jordan Skan: Cardiology Department, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
Amy Chieng: Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA
Maria Crouch: Cardiology Department, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
Rachael C. Aikens: Biomedical Informatics, Stanford University, Stanford, CA 94305, USA
Neal L. Benowitz: Division of Cardiology, Department of Medicine, University of California, San Francisco, CA 94158, USA
Matthew Schnellbaecher: Cardiology Department, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
Judith J. Prochaska: Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA

IJERPH, 2022, vol. 19, issue 16, 1-14

Abstract: Introduction. Innovations 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. Methods. Participants 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. Results. Intervention 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. Discussion. In 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.

Keywords: telehealth; cardiovascular disease; Alaska Native; dietary intake; medication adherence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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