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

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 w...
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Autor*in:	Marily Oppezzo [verfasserIn] Mariah Knox [verfasserIn] Jordan Skan [verfasserIn] Amy Chieng [verfasserIn] Maria Crouch [verfasserIn] Rachael C. Aikens [verfasserIn] Neal L. Benowitz [verfasserIn] Matthew Schnellbaecher [verfasserIn] Judith J. Prochaska [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	telehealth cardiovascular disease Alaska Native dietary intake medication adherence

Übergeordnetes Werk:	In: International Journal of Environmental Research and Public Health - MDPI AG, 2005, 19(2022), 9885, p 9885
Übergeordnetes Werk:	volume:19 ; year:2022 ; number:9885, p 9885

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.3390/ijerph19169885

Katalog-ID:	DOAJ030372526

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allfields	10.3390/ijerph19169885 doi (DE-627)DOAJ030372526 (DE-599)DOAJe3636985dd8c42d0bb408b1c0dbac441 DE-627 ger DE-627 rakwb eng Marily Oppezzo verfasserin aut Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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. telehealth cardiovascular disease Alaska Native dietary intake medication adherence Medicine R Mariah Knox verfasserin aut Jordan Skan verfasserin aut Amy Chieng verfasserin aut Maria Crouch verfasserin aut Rachael C. Aikens verfasserin aut Neal L. Benowitz verfasserin aut Matthew Schnellbaecher verfasserin aut Judith J. Prochaska verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 19(2022), 9885, p 9885 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:19 year:2022 number:9885, p 9885 https://doi.org/10.3390/ijerph19169885 kostenfrei https://doaj.org/article/e3636985dd8c42d0bb408b1c0dbac441 kostenfrei https://www.mdpi.com/1660-4601/19/16/9885 kostenfrei https://doaj.org/toc/1661-7827 Journal toc kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 9885, p 9885
spelling	10.3390/ijerph19169885 doi (DE-627)DOAJ030372526 (DE-599)DOAJe3636985dd8c42d0bb408b1c0dbac441 DE-627 ger DE-627 rakwb eng Marily Oppezzo verfasserin aut Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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. telehealth cardiovascular disease Alaska Native dietary intake medication adherence Medicine R Mariah Knox verfasserin aut Jordan Skan verfasserin aut Amy Chieng verfasserin aut Maria Crouch verfasserin aut Rachael C. Aikens verfasserin aut Neal L. Benowitz verfasserin aut Matthew Schnellbaecher verfasserin aut Judith J. Prochaska verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 19(2022), 9885, p 9885 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:19 year:2022 number:9885, p 9885 https://doi.org/10.3390/ijerph19169885 kostenfrei https://doaj.org/article/e3636985dd8c42d0bb408b1c0dbac441 kostenfrei https://www.mdpi.com/1660-4601/19/16/9885 kostenfrei https://doaj.org/toc/1661-7827 Journal toc kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 9885, p 9885
allfields_unstemmed	10.3390/ijerph19169885 doi (DE-627)DOAJ030372526 (DE-599)DOAJe3636985dd8c42d0bb408b1c0dbac441 DE-627 ger DE-627 rakwb eng Marily Oppezzo verfasserin aut Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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. telehealth cardiovascular disease Alaska Native dietary intake medication adherence Medicine R Mariah Knox verfasserin aut Jordan Skan verfasserin aut Amy Chieng verfasserin aut Maria Crouch verfasserin aut Rachael C. Aikens verfasserin aut Neal L. Benowitz verfasserin aut Matthew Schnellbaecher verfasserin aut Judith J. Prochaska verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 19(2022), 9885, p 9885 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:19 year:2022 number:9885, p 9885 https://doi.org/10.3390/ijerph19169885 kostenfrei https://doaj.org/article/e3636985dd8c42d0bb408b1c0dbac441 kostenfrei https://www.mdpi.com/1660-4601/19/16/9885 kostenfrei https://doaj.org/toc/1661-7827 Journal toc kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 9885, p 9885
allfieldsGer	10.3390/ijerph19169885 doi (DE-627)DOAJ030372526 (DE-599)DOAJe3636985dd8c42d0bb408b1c0dbac441 DE-627 ger DE-627 rakwb eng Marily Oppezzo verfasserin aut Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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. telehealth cardiovascular disease Alaska Native dietary intake medication adherence Medicine R Mariah Knox verfasserin aut Jordan Skan verfasserin aut Amy Chieng verfasserin aut Maria Crouch verfasserin aut Rachael C. Aikens verfasserin aut Neal L. Benowitz verfasserin aut Matthew Schnellbaecher verfasserin aut Judith J. Prochaska verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 19(2022), 9885, p 9885 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:19 year:2022 number:9885, p 9885 https://doi.org/10.3390/ijerph19169885 kostenfrei https://doaj.org/article/e3636985dd8c42d0bb408b1c0dbac441 kostenfrei https://www.mdpi.com/1660-4601/19/16/9885 kostenfrei https://doaj.org/toc/1661-7827 Journal toc kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 9885, p 9885
allfieldsSound	10.3390/ijerph19169885 doi (DE-627)DOAJ030372526 (DE-599)DOAJe3636985dd8c42d0bb408b1c0dbac441 DE-627 ger DE-627 rakwb eng Marily Oppezzo verfasserin aut Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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. telehealth cardiovascular disease Alaska Native dietary intake medication adherence Medicine R Mariah Knox verfasserin aut Jordan Skan verfasserin aut Amy Chieng verfasserin aut Maria Crouch verfasserin aut Rachael C. Aikens verfasserin aut Neal L. Benowitz verfasserin aut Matthew Schnellbaecher verfasserin aut Judith J. Prochaska verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 19(2022), 9885, p 9885 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:19 year:2022 number:9885, p 9885 https://doi.org/10.3390/ijerph19169885 kostenfrei https://doaj.org/article/e3636985dd8c42d0bb408b1c0dbac441 kostenfrei https://www.mdpi.com/1660-4601/19/16/9885 kostenfrei https://doaj.org/toc/1661-7827 Journal toc kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 9885, p 9885
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author	Marily Oppezzo
spellingShingle	Marily Oppezzo misc telehealth misc cardiovascular disease misc Alaska Native misc dietary intake misc medication adherence misc Medicine misc R Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention
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topic_title	Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention telehealth cardiovascular disease Alaska Native dietary intake medication adherence
topic	misc telehealth misc cardiovascular disease misc Alaska Native misc dietary intake misc medication adherence misc Medicine misc R
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title	Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention
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author_browse	Marily Oppezzo Mariah Knox Jordan Skan Amy Chieng Maria Crouch Rachael C. Aikens Neal L. Benowitz Matthew Schnellbaecher Judith J. Prochaska
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title_sort	traditional heart-healthy diet and medication adherence in the norton sound region: an 18-month telehealth intervention
title_auth	Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention
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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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.
abstractGer	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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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.
abstract_unstemmed	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 (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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.
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title_short	Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention
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author2	Mariah Knox Jordan Skan Amy Chieng Maria Crouch Rachael C. Aikens Neal L. Benowitz Matthew Schnellbaecher Judith J. Prochaska
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Intervention effects were significant for the heart-healthy foods ratio at 6 months only (<i<p</i< = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (<i<p</i< = 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. 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Traditional Heart-Healthy Diet and Medication Adherence in the Norton Sound Region: An 18-Month Telehealth Intervention

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