Larson 2009.
Methods |
Study design: controlled before‐after study (independent samples, multiple time points) Sampling frame: adult residents of Tennessee with working telephone Sampling method: random‐digit dial Collection method: telephone interview (n = 21,064) Description of the community coalition: The Nashville Health Disparities Coalition was formed in response to CDC's REACH 2010 funding. The lead agency was a local comprehensive health center, and other coalition organizations included local universities, county hospital, public health department, grassroots organizations, ministers, faith‐based organizations, and concerned citizens. The first 10 community members recruited became the Community Action Plan Committee, which would develop the mission and vision for the group, create bylaws, and elect officers. 4 strategy teams were created to focus on tobacco use, obesity, screening, and access to health care. Each team was staffed by a community health educator and a community outreach worker |
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Participants |
Communities: all Tennessee communities included in analysis, with North Nashville community as intervention group Country: USA Ages included in assessment: 18+ Reasons provided for selection of intervention community: decision based on data indicating that African American residents had significantly higher age‐adjusted death rates due to cardiovascular disease and diabetes compared with whites in the same county Intervention community (population size): North Nashville (42,000) Comparison community (population size): Tennessee State (not reported) |
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Interventions |
Name of intervention: Nashville REACH 2010 Initiative Theory: Social‐Ecologic Model Aim: to reduce disparities in heart disease and diabetes among African Americans in North Nashville, TN Description of costs and resources: not reported Components of the intervention: Hundreds of community actions were documented during the initiative, including changes in infrastructure such as expanded clinic hours, educational campaigns, smoking cessation classes and support groups, advocacy training to help volunteers impact smoking policy at the organizational level, health screenings, and activities to promote healthy eating and exercise Start date: 2001 Duration: 5 years |
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Outcomes |
Outcomes and measures
Time points: baseline (2001) and annually thereafter (2002 to 2005) |
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Notes | Results from the latter outcome group have not yet been published in manuscript form, and lack detailed descriptions of Methods and Results Funding source: government |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Intervention was not randomly assigned |
Allocation concealment (selection bias) | High risk | No allocation concealment |
Baseline outcome measurement similar | Unclear risk | Age‐standardized proportions of smokers similar between target population and other Tennessee African Americans. No baseline data are presented for analyses of body mass index, physical activity, eating behaviors, diabetes, or heart disease |
Baseline characteristics similar | High risk | Age and gender distributions differed significantly between target group and other Tennessee African Americans. No other characteristics compared |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Population‐based telephone survey |
Incomplete outcome data (attrition bias) All outcomes | High risk | Response rates declined over time(from 68% to 46%) in target population; no response rates presented for comparison group |
Blinding of participants and personnel (performance bias) All outcomes | High risk | No blinding reported |
Protection against contamination | Unclear risk | No efforts to protect against contamination reported. Intervention and comparison groups within the same state |
Selective reporting (reporting bias) | Low risk | Main outcomes are reported |