# Engaging NHPIs and Activating Communities to Take Steps (ENACTS)

> **NIH NIH U54** · WASHINGTON STATE UNIVERSITY · 2020 · $137,297

## Abstract

PROJECT 3 
Abstract 
Hypertension is a strong but modifiable risk factor for cardiovascular disease and stroke. Compared to Whites, 
Native Hawaiians and Pacific Islanders (NHPIs) are 3 to 4 times more likely to develop these conditions. They 
also manifest at younger ages among NHPIs, and are more likely to be fatal than in the all-races population. 
Hypertension prevalence is 70% higher in NHPIs than in Whites, and nearly 50% of NHPIs over the age of 21 
have hypertension. Yet, NHPIs are largely absent from research on this topic. Many NHPIs consume diets high 
in sodium and sugar. Education on self-care for reducing sodium intake, increasing potassium intake, and 
encouraging weight loss, smoking cessation, and physical activity can improve blood pressure (BP). We will 
adapt an existing educational intervention to address self-management of hypertension in NHPIs. The multilevel 
6-month intervention – “Engaging NHPIs and Activating Communities to Take Steps” (ENACTS) – will operate 
use peer-facilitated, self-care BP education delivered weekly for 8 weeks emphasizing healthy diet, traditional 
NHPI foods, adherence to medication, and encouragement to increase physical activity and stop smoking; with 
text messaging to boost adherence. We will implement ENACTS as a randomized controlled trial at 3 community 
sites serving NHPIs in the Puget Sound area of Washington. We will randomize 270 NHPI adults (90 per site) 
with a self-reported physician diagnosis of hypertension and elevated BP measured at enrollment to either 
ENACTS or usual care. Both groups will receive general health education brochures, plus a $30 weekly credit 
for online grocery shopping. We will use a Geographic Information Systems (GIS) mobile phone app to track 
participants. The primary outcome is change in systolic BP. Secondary outcomes are food purchasing behaviors 
(online ordering, grocery receipts); medication adherence; social support; smoking cessation; and GIS data on 
daily energy expenditure. Outcomes will be measured at baseline, weekly, and at 6 months. We will also examine 
change in household food purchasing patterns, enhanced family support for BP control, and BP improvement 
among family members. A subset of intervention participants and family members will be invited to participate in 
a program that uses personal photographs for narrative art projects to promote labeling of healthy foods by local 
retail outlets. Our Specific Aims are: 1) at the individual level, to compare within-person change in BP and 
secondary outcomes between the intervention and control groups; 2) at the family level, to evaluate ENACTS’ 
effects on BP and secondary outcomes as within-person change in family members who provide primary support, 
and as mean change in other adult family members who are not directly engaged in the intervention; and 3) at 
the policy level, to evaluate the intervention’s ability to influence grocery store policy on clearly identifying foods 
that are ...

## Key facts

- **NIH application ID:** 9868832
- **Project number:** 5U54MD011240-05
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** KA'IMI ALOHILANI SINCLAIR
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $137,297
- **Award type:** 5
- **Project period:** — → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9868832

## Citation

> US National Institutes of Health, RePORTER application 9868832, Engaging NHPIs and Activating Communities to Take Steps (ENACTS) (5U54MD011240-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9868832. Licensed CC0.

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