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PREMIER—A Trial of Lifestyle Interventions for Blood Pressure Control: Intervention Design and Rationale

Center for Health Research, Kaiser Permanente Northwest, in Portland, Oregon

Patricia J. Elmer, PhD

Center for Health Research, Kaiser Permanente Northwest, in Portland, Oregon

Victor J. Stevens, PhD

Center for Health Research, Kaiser Permanente Northwest in Portland, Oregon

David W. Harsha, PhD

Body Composition Laboratory at Pennington Biomedical Research Center in Baton Rouge, Louisiana

Shirley R. Craddick, MHA, RD

Center for Health Research, Kaiser Permanente Northwest, in Portland, Oregon

Pao-Hwa Lin, PhD

Sarah Stedman Center for Nutritional Studies at Duke University Medical Center in Durham, North Carolina

Deborah Rohm Young, PhD

Department of Kinesiology at the University of Maryland in College Park, Maryland

Catherine M. Champagne, PhD, RD

Analysis Core Department at Pennington Biomedical Research Center in Baton Rouge, Louisiana

Phillip J. Brantley, PhD

Behavioral Medicine Laboratory at Pennington Biomedical Research Center in Baton Rouge, Louisiana

Phyllis B. McCarron, MS, RD

Welch Center for Prevention, Epidemiology and Clinical Research in Baltimore, Maryland

Denise G. Simons-Morton, MD, PhD

Division of Epidemiology and Clinical Applications, National Heart, Lung, Blood Institute, National Institutes of Health, in Bethesda, Maryland

Lawrence J. Appel, MD

Johns Hopkins School of Medicine in Baltimore, Maryland

Interventions encouraging adoption of healthy diets and increased physical activity are needed to achieve national goals for preventing and treating hypertension, cardiovascular disease, diabetes, and other chronic diseases. PREMIER was a multicenter clinical trial testing the effects of two lifestyle interventions on blood pressure control, compared with advice only. Both interventions implemented established national guidelines for blood pressure control (weight loss, reduced sodium and alcohol intake, and increased physical activity), and one intervention also included the Dietary Approaches to Stop Hypertension (DASH) diet. Both interventions focused on behavioral self-management, motivational enhancement, and personalized feedback. This article describes the design and evaluation approaches for these interventions. Evaluation of multicomponent lifestyle change interventions can help us understand the benefits and difficulties of making multiple lifestyle changes concurrently and the effects such changes can have on blood pressure, particularly in minorities at higher risk for hypertension.

Key Words: hypertension • diet • physical activity • behavioral intervention • blood pressure • DASH

This version was published on July 1, 2008

Health Promotion Practice, Vol. 9, No. 3, 271-280 (2008)
DOI: 10.1177/1524839906289035


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