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Williams LB, Abu Farsakh B, Karle ER, Almogheer ZS, Coughlin S, Kim Yeary KH. How effective are church-based weight-loss interventions among Black adults? A systematic review. Obesity (Silver Spring) 2024. [PMID: 39199014 DOI: 10.1002/oby.24115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/18/2024] [Accepted: 06/10/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE Churches are frequently used to reach Black adults to effect weight loss. However, there has been no recent review, to our knowledge, inclusive of solely Black adults in church settings. We sought to comprehensively examine the methodological approaches and weight-loss outcomes of church-based weight-loss lifestyle interventions conducted among Black adults to provide insights on literature gaps and offer suggestions for future research. METHODS Google Scholar, PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for trials conducted in churches that reported weight outcomes at any time point. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guided manuscript development. RESULTS A total of 15 studies (N = 2285) from 2007 to 2023 met inclusion criteria, and 33% were high-quality randomized trials. The majority were pilot studies (60%) conducted in the Southern United States. Most reported significant postintervention weight loss. The follow-up time points varied from 2 to 12 months. Methodological approaches included the following: cultural adaptations (93%); theory-guided (93%); delivered by community health workers (80%); and delivered in person in a group format (100%). Only one study offered individual-level attention beyond texts/emails. Most participants were well-educated female individuals. CONCLUSIONS Weight-loss interventions among Black church settings effect statistically significant weight loss, albeit in a small way. Limitations include pilot studies and small samples. More rigorously designed studies are warranted.
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Affiliation(s)
| | | | - Erika R Karle
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | | | - Steven Coughlin
- College of Allied Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Karen H Kim Yeary
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Ashe J, Bentley-Edwards K, Skipper A, Cuevas A, Vieytes CM, Bah K, Evans MK, Zonderman AB, Waldstein SR. Racial Discrimination, Religious Coping, and Cardiovascular Disease Risk Among African American Women and Men. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02113-x. [PMID: 39160432 DOI: 10.1007/s40615-024-02113-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 07/10/2024] [Accepted: 07/26/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVE This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors-systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol-in a sample of African American women and men. METHODS Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30-64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed. RESULTS In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination. CONCLUSION Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.
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Affiliation(s)
- Jason Ashe
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA.
| | - Keisha Bentley-Edwards
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Duke Cancer Institute, Duke University, Durham, NC, USA
- Samuel DuBois Cook Center On Social Equity, Duke University, Durham, NC, USA
| | - Antonius Skipper
- The Gerontology Institute, Georgia State University, Atlanta, GA, USA
| | - Adolfo Cuevas
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
- Center for Anti-Racism, Social Justice, and Public Health, New York University School of Global Public Health, New York, NY, USA
| | - Christian Maino Vieytes
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - Kristie Bah
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA
- Division of Gerontology, Geriatrics, and Palliative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Alvarado F, Allouch F, Laurent J, Chen J, Bundy JD, Gustat J, Crews DC, Mills KT, Ferdinand KC, He J. Neighborhood-level social determinants of health and cardioprotective behaviors among church members in New Orleans, Louisiana. Am J Med Sci 2024; 368:9-17. [PMID: 38556001 DOI: 10.1016/j.amjms.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/13/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Favorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana. METHODS Participants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data). Logistic regression models were used to assess the relation of neighborhood factors with the likelihood of engaging in cardioprotective behaviors: 1) a composite of healthy lifestyle behaviors [fruit and vegetable consumption, physical activity, and a tobacco/nicotine-free lifestyle], 2) medication adherence, and 3) receipt of routine medical care within the past year. RESULTS Participants (n = 302, mean age: 63 years, 77% female, 99% Black) were recruited from 12 churches in New Orleans. After adjusting for demographic and clinical factors, perceived neighborhood walkability or conduciveness to exercise (odds ratio [OR]=1.25; 95% CI: 1.03, 1.53), availability of fruits and vegetables (OR=1.23; 95% CI: 1.07, 1.42), and social cohesion (OR=1.55; 95% CI: 1.22, 1.97) were positively associated with the composite of healthy lifestyle behaviors. After multivariable adjustment, SDI was in the direction of association with all three cardioprotective behavior outcomes, but associations were not statistically significant. CONCLUSIONS In this predominantly Black, church-based population, neighborhood-level SDoH including the availability of fruits and vegetables, walkability or conduciveness to exercise, and social cohesion were associated with cardioprotective behaviors. Findings reiterate the need to address adverse neighborhood-level SDoH in the design and implementation of health interventions.
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Affiliation(s)
- Flor Alvarado
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Farah Allouch
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jodie Laurent
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jing Chen
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joshua D Bundy
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jeanette Gustat
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Deidra C Crews
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine T Mills
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Keith C Ferdinand
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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Berkley-Patton J, Thompson CB, Templeton T, Finocchario-Kessler S, Williams E, Wainright C, Materia FT, Dennis L, Catley D, Burgin T, Derose KP, Bradley-Ewing A, Geyer A, Ellison SR, Allsworth JE. Have a Little Faith: Overcoming Pandemic-Related Challenges to Designing and Implementing a COVID-19 Testing Trial in African American Churches. Am J Public Health 2024; 114:S366-S371. [PMID: 38776493 PMCID: PMC11111378 DOI: 10.2105/ajph.2024.307607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Jannette Berkley-Patton
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Carole Bowe Thompson
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Turquoise Templeton
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Sarah Finocchario-Kessler
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Eric Williams
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Cassandra Wainright
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Frank T Materia
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Lesha Dennis
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Delwyn Catley
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Tacia Burgin
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Kathryn P Derose
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Andrea Bradley-Ewing
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Alex Geyer
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Stefanie R Ellison
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Jenifer E Allsworth
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
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Cummings T, Skelton KR. Reducing CVD health disparities in Black women through addressing social determinants of health (SDOH): a scoping review. Women Health 2024; 64:350-364. [PMID: 38616625 DOI: 10.1080/03630242.2024.2337719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
Cardiovascular disease (CVD) disparities among Black American women can be linked directly to social determinants of health (SDOH). This scoping review examines the breadth and depth of existing literature on CVD risk reduction interventions in young-to-middle-aged women that address SDOH. We searched PubMed, CINAHL, Scopus and Google Scholar for relevant peer-reviewed articles published in English. We included studies if they reported on the feasibility, acceptability, or findings of a CVD risk reduction intervention, addressed at least one SDOH domain, and included Black women 18-45 years of age. Of the 2,533 studies screened, 5 studies were eligible for inclusion. Specific SDOH domains addressed included: social and community context and health-care access and quality. All but one study reported culturally tailored intervention components. Feasibility and acceptability of culturally tailored interventions was high among included studies examining this outcome. Recommendations for future research focused on the need for additional interventions that were culturally tailored to young- and middle-aged Black women. Future research should work to address existing evidence gaps via development and implementation of culturally tailored, CVD risk reduction and disease prevention interventions for young-to-middle-aged Black women that focus addressing SDOH, as these types of interventions demonstrate promise for reducing CVD health disparities among Black women.
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Affiliation(s)
- Tyesha Cummings
- Department of Health Sciences, Towson University, Towson, Maryland, USA
| | - Kara R Skelton
- Department of Health Sciences, Towson University, Towson, Maryland, USA
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6
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Bauer AG, Shah B, Johnson N, Aduloju-Ajijola N, Bowe-Thompson C, Christensen K, Berkley-Patton JY. Feasibility and Acceptability of the Project Faith Influencing Transformation Intervention in Faith-Based Settings. HEALTH EDUCATION & BEHAVIOR 2024; 51:291-301. [PMID: 37978814 DOI: 10.1177/10901981231211538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.
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Affiliation(s)
- Alexandria G Bauer
- Rutgers University-New Brunswick, Piscataway, NJ, USA
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Binoy Shah
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Nia Johnson
- Saint Louis University School of Medicine, St. Louis, MO, USA
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7
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ElSayed NA, Bannuru RR, Bakris G, Bardsley J, de Boer IH, Gabbay RA, Gockerman J, McCoy RG, McCracken E, Neumiller JJ, Pilla SJ, Rhee CM. Diabetic Kidney Disease Prevention Care Model Development. Clin Diabetes 2023; 42:274-294. [PMID: 38694240 PMCID: PMC11060626 DOI: 10.2337/cd23-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
More than one-third of people with diabetes develop diabetic kidney disease (DKD), which substantially increases risks of kidney failure, cardiovascular disease (CVD), hypoglycemia, death, and other adverse health outcomes. A multifaceted approach incorporating self-management education, lifestyle optimization, pharmacological intervention, CVD prevention, and psychosocial support is crucial to mitigate the onset and progression of DKD. The American Diabetes Association convened an expert panel to develop the DKD Prevention Model presented herein. This model addresses prevention and treatment, including screening guidelines, diagnostic tools, and management approaches; comprehensive, holistic interventions; well-defined roles for interdisciplinary health care professionals; community engagement; and future directions for research and policy.
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Affiliation(s)
- Nuha A. ElSayed
- American Diabetes Association, Alexandria, VA
- Harvard Medical School, Boston, MA
| | | | - George Bakris
- Department of Medicine, American Heart Association Comprehensive Hypertension Center, University of Chicago School of Medicine, Chicago, IL
| | - Joan Bardsley
- MedStar Health Research Institute and MedStar System Nursing, Columbia, MD
| | - Ian H. de Boer
- Division of Nephrology, University of Washington School of Medicine, Seattle, WA
| | | | | | - Rozalina G. McCoy
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, University of Maryland Institute for Health Computing, Rockville, MD
| | | | - Joshua J. Neumiller
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA
- Providence Medical Research Center, Providence Health Care, Spokane, WA
| | - Scott J. Pilla
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Connie M. Rhee
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine School of Medicine, Irvine, CA
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8
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Ling I, Zambrana RE, Echeverria S, López L. Peer Support to Enhance Type 2 Diabetes Prevention Among African American and Latino Adults. Endocrinol Metab Clin North Am 2023; 52:573-583. [PMID: 37865474 DOI: 10.1016/j.ecl.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Social support occurs within complex social networks that are diffusely embedded within the social determinants of health. Social networks operate through five primary interconnected pathways: (1) provision of social support; (2) social influence; (3) social engagement; (4) social capital; and (5) social cohesion. Research has demonstrated that increased social support can have a beneficial impact on Type 2 Diabetes (T2DM) prevention and outcomes through culturally tailored Diabetes Prevention Programs in minority communities. Further research is needed to fully measure the impact of social network peer support on T2DM outcomes to better operationalize and scale up community specific interventions.
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Affiliation(s)
- Irving Ling
- Kaiser Permanente Northern California, 2425 Geary Boulevard, San Francisco, CA 94115, USA
| | - Ruth Enid Zambrana
- Harriet Tubman Department of Women, Gender and Sexuality Studies, University of Maryland, Consortium on Race, Gender and Ethnicity, Susquehanna Hall, 4200 Lehigh Road Room 4117, College Park, MD 20742, USA
| | - Sandra Echeverria
- Department of Public Health Education, 437 Coleman Building, 1408 Walker Avenue, Greensboro, NC 27412, USA
| | - Lenny López
- University of California San Francisco, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
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Thomas VE, Metlock FE, Hines AL, Commodore-Mensah Y, Brewer LC. Community-Based Interventions to Address Disparities in Cardiometabolic Diseases Among Minoritized Racial and Ethnic Groups. Curr Atheroscler Rep 2023; 25:467-477. [PMID: 37428390 DOI: 10.1007/s11883-023-01119-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW Cardiometabolic diseases (CMDs) are leading causes of death and disproportionally impact historically marginalized racial/ethnic groups in the United States. The American Heart Association developed the Life's Essential 8 (LE8) to promote optimal cardiovascular health (CVH) through eight health behaviors and health factors. The purpose of this review is to summarize contemporary community-engaged research (CER) studies incorporating the LE8 framework among racial/ethnic groups. REVIEW OF FINDINGS Limited studies focused on the interface of CER and LE8. Based on synthesis of articles in this review, the application of CER to individual/collective LE8 metrics may improve CVH and reduce CMDs at the population level. Effective strategies include integration of technology, group activities, cultural/faith-based practices, social support, and structural/environmental changes. CER studies addressing LE8 factors in racial/ethnic groups play an essential role in improving CVH. Future studies should focus on broader scalability and health policy interventions to advance health equity.
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Affiliation(s)
- Victoria E Thomas
- Division of Cardiovascular Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Faith E Metlock
- John Hopkins University School of Nursing, Baltimore, MD, USA
| | - Anika L Hines
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Yvonne Commodore-Mensah
- John Hopkins University School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - LaPrincess C Brewer
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
- Mayo Clinic Center for Health Equity and Community Engagement Research, Rochester, MN, USA.
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10
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Strayhorn SM, Carter A, Harmon BE, Hébert JR. An Examination of Culturally Relevant Health Messages in African-American Churches. JOURNAL OF RELIGION AND HEALTH 2023; 62:2547-2562. [PMID: 35994186 PMCID: PMC9943804 DOI: 10.1007/s10943-022-01638-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 05/07/2023]
Abstract
This quantitative study examined the presence of culturally relevant health messages for African-Americans based on a preexisting dataset from 21 African-American churches in South Carolina (USA). Content analysis served as the primary methodological approach to code printed media messages based on their cultural relevance among African-Americans (Cohen's kappa = .74). Within the dataset (n = 2166), 477 (22%) items were identified as culturally relevant. A low prevalence of culturally relevant messages was found across the three message topics, two media types, and one media source. Due to the limited presence of culturally relevant messages, researchers should collaborate with African-American churches to design health promotion messages.
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Affiliation(s)
- Shaila M Strayhorn
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, 601 S. College Road, Wilmington, NC, 28403, USA
| | - Andrew Carter
- Department of Public Health and Recreation, San José State University, One Washington Square, San José, CA, 95192, USA
| | - Brook E Harmon
- Department of Nutrition and Health Care Management, Beaver College of Health Sciences, Appalachian State University, 1179 State Farm Rd, Boone, NC, 28607, USA.
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Statewide Cancer Prevention and Control Program, University of South Carolina, 242 Discovery 1, Columbia, SC, 29208, USA
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11
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Welch V, Pottie K, Gaudet C, Thuku M, Mallard R, Spenceley S, Amjed N, Wadhwani A, Ghogomu E, Scott C, Dahrouge S. Realist review of community coalitions and outreach interventions to increase access to primary care for vulnerable populations: a realist review. Arch Public Health 2023; 81:115. [PMID: 37353828 DOI: 10.1186/s13690-023-01105-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND There are meaningful gaps in equitable access to Primary Health Care (PHC), especially for vulnerable populations after widespread reforms in Western countries. The Innovative Models Promoting Access-to-Care Transformation (IMPACT) research program is a Canadian-Australian collaboration that aims to improve access to PHC for vulnerable populations. Relationships were developed with stakeholders in six regions across Canada and Australia where access-related needs could be identified. The most promising interventions would be implemented and tested to address the needs identified. This realist review was conducted to understand how community coalition and outreach (e.g., mobile or pop-up) services improve access for underserved vulnerable residents. OBJECTIVE To inform the development and delivery of an innovative intervention to increase access to PHC for vulnerable populations. METHODS A realist review was conducted in collaboration with the Local Innovative Partnership (LIP) research team and the IMPACT research members who conducted the review. We performed an initial comprehensive systematic search using MEDLINE, EMBASE, PsycINFO, and the Cochrane Library up to October 19, 2015, and updated it on August 8, 2020. Studies were included if they focused on interventions to improve access to PHC using community coalition, outreach services or mobile delivery methods. We included Randomized Controlled Trials (RCTs), and systematic reviews. Studies were screened by two independent reviewers and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used for data extraction and framework analysis to obtain themes. The LIP research team was also allowed to suggest additional papers not included at screening. RESULTS We included 43 records, comprising 31 RCTs, 11 systematic reviews, and 1 case control study that was added by the LIP research team. We identified three main themes of PHC interventions to promote access for vulnerable residents, including: 1) tailoring of materials and services decreases barriers to primary health care, 2) services offered where vulnerable populations gather increases the "reach" of the interventions, 3) partnerships and collaborations lead to positive health outcomes. In addition, implementation designs and reporting elements should be considered. CONCLUSION Realist reviews can help guide the development of locally adapted primary health care interventions.
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Affiliation(s)
- Vivian Welch
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada.
| | - Kevin Pottie
- Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre (CTLC), 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Caroline Gaudet
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Micere Thuku
- Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre (CTLC), 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Ryan Mallard
- University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Shannon Spenceley
- University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 6T5, Canada
| | - Nida Amjed
- Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada
| | - Arpana Wadhwani
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Elizabeth Ghogomu
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Cathie Scott
- PolicyWise for Children & Families, #1000, 9925 109 Street, Edmonton, AB, T5K 2J8, Canada
| | - Simone Dahrouge
- Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre (CTLC), 85 Primrose, Ottawa, ON, K1R 7G5, Canada
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12
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Swindle T, Baloh J, Landes SJ, Lovelady NN, Vincenzo JL, Hamilton AB, Zielinski MJ, Teeter BS, Gorvine MM, Curran GM. Evidence-Based Quality Improvement (EBQI) in the pre-implementation phase: key steps and activities. FRONTIERS IN HEALTH SERVICES 2023; 3:1155693. [PMID: 37292120 PMCID: PMC10244502 DOI: 10.3389/frhs.2023.1155693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023]
Abstract
Background Evidence-Based Quality Improvement (EBQI) involves researchers and local partners working collaboratively to support the uptake of an evidence-based intervention (EBI). To date, EBQI has not been consistently included in community-engaged dissemination and implementation literature. The purpose of this paper is to illustrate the steps, activities, and outputs of EBQI in the pre-implementation phase. Methods The research team applied comparative case study methods to describe key steps, activities, and outputs of EBQI across seven projects. Our approach included: (1) specification of research questions, (2) selection of cases, (3) construction of a case codebook, (4) coding of cases using the codebook, and (5) comparison of cases. Results The cases selected included five distinct settings (e.g., correction facilities, community pharmacies), seven EBIs (e.g., nutrition promotion curriculum, cognitive processing therapy) and five unique lead authors. Case examples include both community-embedded and clinically-oriented projects. Key steps in the EBQI process included: (1) forming a local team of partners and experts, (2) prioritizing implementation determinants based on existing literature/data, (3) selecting strategies and/or adaptations in the context of key determinants, (4) specifying selected strategies/adaptations, and (5) refining strategies/adaptations. Examples of activities are included to illustrate how each step was achieved. Outputs included prioritized determinants, EBI adaptations, and implementation strategies. Conclusions A primary contribution of our comparative case study is the delineation of various steps and activities of EBQI, which may contribute to the replicability of the EBQI process across other implementation research projects.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jure Baloh
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Sara J. Landes
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Behavioral Health Quality Enhancement Research Initiative (QUERI), Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Nakita N. Lovelady
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jennifer L. Vincenzo
- Department of Physical Therapy, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Alison B. Hamilton
- Center for the Study of Healthcare Innovation, Implementation, & Policy; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Melissa J. Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Benjamin S. Teeter
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Margaret M. Gorvine
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Geoffrey M. Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
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13
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Huang HC, Szwerinski NK, Nasrallah C, Huang Q, Chopra V, Venditti EM, Azar KMJ, Romanelli RJ. Lifestyle change program engagement in real-world clinical practice: a mixed-methods analysis. Transl Behav Med 2023; 13:168-182. [PMID: 36694916 PMCID: PMC10068905 DOI: 10.1093/tbm/ibac098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Participant engagement in structured lifestyle change programs (LCPs) is essential for adopting behaviors that promote weight loss; however, the challenges to, and facilitators that promote, engagement with such programs are not well understood. We conducted a mixed-methods study among real-world LCP participants to assess factors associated with program engagement and to examine the reasons for withdrawal. Using electronic health records (EHR), we identified LCP eligible participants between 2010 and 2017. Multivariable logistic regression was used to assess associations between program engagement and baseline characteristics. Semi-structured interviews with LCP participants were conducted and thematically analyzed to examine reasons for withdrawal. A total of 1,813 LCP participants were included. The median number of sessions attended was 10 of 21-25 sessions. Highest LCP engagement was associated with factors potentially related to self-efficacy/motivation, such as older age, higher baseline weight, prior healthcare utilization and an absence of a history of smoking or depression. Engagement was also negatively associated with being Non-Hispanic Black versus White. The qualitative analysis of the interviews revealed four general themes pertaining to participants' withdrawal: competing priorities, perceived program effectiveness, characteristics of the program, and facilitator-related factors. Taken together, results from this mixed-methods study suggest that motivation and self-efficacy are important for program engagement; future LCP enhancements should incorporate flexible formats that may help participants manage competing priorities and maximize personal and cultural relevance for all racial/ethnic groups, especially those who have not benefitted fully. Furthermore, participants should be encouraged to set realistic goals to manage expectations.
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Affiliation(s)
- Hsiao-Ching Huang
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Nina K Szwerinski
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | | | - Qiwen Huang
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Vidita Chopra
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Elizabeth M Venditti
- Department of Psychiatry, Diabetes Prevention Support Center, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Epidemiology, Diabetes Prevention Support Center, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kristen M J Azar
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Robert J Romanelli
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
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Alvarado F, Hercules A, Wanigatunga M, Laurent J, Payne M, Allouch F, Crews DC, Mills KT, He J, Gustat J, Ferdinand KC. Influence of neighborhood-level social determinants of health on a heart-healthy lifestyle among Black church members: A mixed-methods study. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 27:100273. [PMID: 38511101 PMCID: PMC10946005 DOI: 10.1016/j.ahjo.2023.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/22/2024]
Abstract
Background Few church-based health interventions have evaluated the influence of neighborhood-level social determinants of health (SDOH) on adopting heart-healthy lifestyles; none has occurred in Louisiana. We aimed to characterize neighborhood-level SDOH that may influence the ability to adopt a heart-healthy lifestyle among Black community church members in New Orleans, LA. Methods This mixed methods study used quantitative data (surveys) and qualitative data (focus groups) to explore SDOH at the neighborhood- and church-area- level, including factors related to the physical (e.g., walkability, accessibility to recreational facilities) and social (e.g., social cohesion, perceived safety) environments. Descriptive analyses were conducted for quantitative data. Qualitative data were coded and analyzed using grounded theory and thematic analysis. Results Among survey respondents (n = 302, 77 % female, 99 % Black), most reported having walkable neighborhood sidewalks and high neighborhood social cohesion. Two-thirds did not feel violence was a problem in their neighborhood and felt safe walking, day, or night. Focus group participants (n = 27, 74 % female, 100 % Black) reported facilitators to heart-healthy living, including social support promoting physical activity, intentionality in growing, buying, and preparing produce, and the neighborhood-built environment. Reported barriers included: crime, the COVID-19 pandemic, individual-level factors limiting physical activity, and city-wide disparities influencing health. Participants discussed strategies to promote healthy living, centered around the theme of establishing and rebuilding community relationships. Conclusions Future health interventions aimed at improving cardiovascular outcomes among church communities should continue to inquire about neighborhood-level SDOH and tailor interventions, as appropriate, to address barriers and leverage facilitators within these communities.
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Affiliation(s)
- Flor Alvarado
- Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - Amanda Hercules
- Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA
| | - Melanie Wanigatunga
- Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - Jodie Laurent
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA
| | - Marilyn Payne
- Payne and Associates Counseling and Consulting Services, 2371 Lark St, New Orleans, LA, USA
| | - Farah Allouch
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA
| | - Deidra C. Crews
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Katherine T. Mills
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA
| | - Jeanette Gustat
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA
| | - Keith C. Ferdinand
- Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
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Seguin-Fowler RA, Eldridge GD, Rethorst CD, Graham ML, Demment M, Strogatz D, Folta SC, Maddock JE, Nelson ME, Ha S. Improvements and Maintenance of Clinical and Functional Measures Among Rural Women: Strong Hearts, Healthy Communities-2. 0 Cluster Randomized Trial. Circ Cardiovasc Qual Outcomes 2022; 15:e009333. [PMID: 36378768 PMCID: PMC9665948 DOI: 10.1161/circoutcomes.122.009333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular disease is the leading cause of death in the United States; however, women and rural residents face notable health disparities compared with male and urban counterparts. Community-engaged programs hold promise to help address disparities through health behavior change and maintenance, the latter of which is critical to achieving clinical improvements and public health impact. METHODS A cluster-randomized controlled trial of Strong Hearts, Healthy Communities-2.0 conducted in medically underserved rural communities examined health outcomes and maintenance among women aged ≥40 years, who had a body mass index >30 or body mass index 25 to 30 and also sedentary. The multilevel intervention provided 24 weeks of twice-weekly classes with strength training, aerobic exercise, and skill-based nutrition education (individual and social levels), and civic engagement components related to healthy food and physical activity environments (community, environment, and policy levels). The primary outcome was change in weight; additional clinical and functional fitness measures were secondary outcomes. Mixed linear models were used to compare between-group changes at intervention end (24 weeks); subgroup analyses among women aged ≥60 years were also conducted. Following a 24-week no-contact period, data were collected among intervention participants only to evaluate maintenance. RESULTS Five communities were randomized to the intervention and 6 to the control (87 and 95 women, respectively). Significant improvements were observed for intervention versus controls in body weight (mean difference: -3.15 kg [95% CI, -4.98 to -1.32]; P=0.008) and several secondary clinical (eg, waist circumference: -3.02 cm [-5.31 to -0.73], P=0.010; systolic blood pressure: -6.64 mmHg [-12.67 to -0.62], P=0.031; percent body fat: -2.32% [-3.40 to -1.24]; P<0.001) and functional fitness outcomes; results were similar for women aged ≥60 years. The within-group analysis strongly suggests maintenance or further improvement in outcomes at 48 weeks. CONCLUSIONS This cardiovascular disease prevention intervention demonstrated significant, clinically meaningful improvements and maintenance among rural, at-risk older women. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03059472.
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Affiliation(s)
- Rebecca A. Seguin-Fowler
- Institute for Advancing Health through Agriculture, Texas A&M AgriLife, College Station (R.A.S-F.)
| | - Galen D. Eldridge
- Texas A&M AgriLife Research and Extension Center, Dallas (G.D.E., C.D.R., M.L.G., M.D.)
| | - Chad D. Rethorst
- Texas A&M AgriLife Research and Extension Center, Dallas (G.D.E., C.D.R., M.L.G., M.D.)
| | - Meredith L. Graham
- Texas A&M AgriLife Research and Extension Center, Dallas (G.D.E., C.D.R., M.L.G., M.D.)
| | - Margaret Demment
- Texas A&M AgriLife Research and Extension Center, Dallas (G.D.E., C.D.R., M.L.G., M.D.)
| | | | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston (S.C.F., M.E.N.).,Texas A&M University, College Station (S.C.F., M.E.N.)
| | - Jay E. Maddock
- Statistical Collaboration Center, Texas A&M University, College Station (J.E.M., S.H.)
| | - Miriam E. Nelson
- Friedman School of Nutrition Science and Policy, Tufts University, Boston (S.C.F., M.E.N.).,Texas A&M University, College Station (S.C.F., M.E.N.)
| | - Seungyeon Ha
- Statistical Collaboration Center, Texas A&M University, College Station (J.E.M., S.H.)
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Garcia JF, Peters AL, Raymond JK, Fogel J, Orrange S. Equity in Medical Care for People Living With Diabetes. Diabetes Spectr 2022; 35:266-275. [PMID: 36082008 PMCID: PMC9396720 DOI: 10.2337/dsi22-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Disparities and inequities exist for individuals with diabetes in marginalized communities of color, especially among people with low socioeconomic status. Although these barriers are apparent, only a few care models have been designed for and examined in racially and ethnically diverse individuals. This article reviews models that have been developed and examined in a variety of different populations and focuses on how to implement elements from these programs in clinical practice. Health equity-promoting ideas and approaches that can be applied throughout the life span (children to seniors) are also included. As diabetes health care providers, researchers, educators, policymakers, and advocates, we must now combine our efforts and focus on historically excluded populations to bridge the gap to essential diabetes care.
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17
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MacPherson MM, Merry KJ, Locke SR, Jung ME. mHealth prompts within diabetes prevention programs: a scoping review. Mhealth 2022; 8:20. [PMID: 35449504 PMCID: PMC9014231 DOI: 10.21037/mhealth-21-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/04/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) prompts (e.g., text messaging, push notifications) are a commonly used technique within behaviour change interventions to prompt or cue a specific behaviour. Such prompts are being increasingly integrated into diabetes prevention programs (DPPs). While mHealth prompts provide a convenient and cost-effective way to reinforce behaviour change, no reviews to date have examined mHealth prompt use within DPPs. This scoping review aims to: (I) understand how mHealth prompts are being used within behaviour change interventions for individuals at risk for developing type 2 diabetes (T2D); and (II) provide recommendations for future mHealth prompt research, design, and application. METHODS The scoping review methodology outlined by Arksey and O'Malley were followed. Medline, CINAHL, PsycInfo, Web of Science, and SportDiscus were searched. The search strategy combined keywords relating to T2D risk and mHealth prompts in conjunction with database-controlled vocabulary when available (e.g., MeSH for Medline). RESULTS Of the 4,325 publications screened, 44 publications (based on 33 studies) met the inclusion criteria and were included for data extraction. Text messaging was the most widely used mHealth prompt (73%) followed by push notifications (21%). Only 30% of studies discussed the theoretical basis for prompt content and time of day messages were sent, and only 27% provided justification for prompt timing and frequency. Fourteen studies assessed participant satisfaction with mHealth prompts of which only two reported dissatisfaction due to either prompting frequency (hourly) or message content (solely focused on weight). Nine studies assessed behavioural outcomes including weight loss, physical activity, and diabetes incidence, and found mixed effects overall. CONCLUSIONS While mHealth prompts were well-received by participants, there are mixed effects on the influence of mHealth prompts on behavioural outcomes and diabetes incidence. More thorough reporting of prompt content development and delivery is needed, and more experimental research is needed to identify optimal content, delivery characteristics, and impact on behavioural and clinical outcomes.
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Affiliation(s)
- Megan M. MacPherson
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Kohle J. Merry
- School of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
| | - Sean R. Locke
- Department of Kinesiology, Brock University, St. Catherines, Canada
| | - Mary E. Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
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18
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Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups. CURR EPIDEMIOL REP 2022; 9:212-221. [PMID: 36003088 PMCID: PMC9392701 DOI: 10.1007/s40471-022-00298-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 11/11/2022]
Abstract
Purpose of Review This review aims to assess the contemporary community-based participatory research (CBPR) literature seeking to improve the cardiovascular health of racial and ethnic minority groups in the USA with a higher burden of cardiovascular risk factors and social determinants of health. It summarizes recent CBPR studies based on the American Heart Association Life's Simple 7 (LS7) framework, delineating seven modifiable health behaviors and clinical factors to promote cardiovascular health. Recent Findings Although limited in quantity, studies demonstrated preliminary effectiveness in improving individual and a composite of LS7 indicators by employing strategies centered around fortifying social networks, integrating group activities, leveraging technology, incorporating faith-based and spiritual practices, and implementing changes to the built environment. Summary Future directions for investigators engaged in CBPR include building on the existing body of evidence through more comprehensive studies, scaling effective interventions, and translating CBPR findings to influence health policy to better address health disparities.
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19
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Abstract
Diabetes disproportionably affects minorities in the United States. Substantial disparities exist in diabetes incidence, glycemic control, complications, mortality, and management. The most important biologic contributors to diabetes disparities are obesity, insulin resistance, and inadequate glycemic control. Providers and health systems must also recognize the behavioral, social, and environmental factors that promote and sustain racial/ethnic differences in diabetes and its complications. Metformin and sodium-glucose cotransporter 2 inhibitors are the most convenient drugs for treatment of diabetes in minority patients. Multilevel interventions at the patient, provider, health system, community, and policy levels are needed to reduce diabetes disparities in high-risk groups.
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Affiliation(s)
- Nasser Mikhail
- Endocrinology Division, Department of Medicine, Olive View-UCLA Medical Center, David-Geffen-UCLA School of Medicine, Sylmar, CA 91342, USA
| | - Soma Wali
- Department of Medicine, Olive View-UCLA Medical Center, David-Geffen-UCLA School of Medicine, Sylmar, CA 91342, USA
| | - Arleen F Brown
- Department of Medicine, Olive View-UCLA Medical Center, David-Geffen-UCLA School of Medicine, Sylmar, CA 91342, USA.
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20
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Abstract
The global diabetes burden is staggering, and prevention efforts are needed to reduce the impact on individuals and populations. There is strong evidence from efficacy trials showing that lifestyle interventions promoting increased physical activity, improvements in diet, and/or weight loss significantly reduce diabetes incidence and improve cardiometabolic risk factors. Implementation research assessing the feasibility, effectiveness, and cost-effectiveness of delivering these proven programs at the community level has shown success, but more research is needed to overcome barriers to implementation in different settings globally. New avenues of research should be considered to combat this public health issue.
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Affiliation(s)
- Mary Beth Weber
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA.
| | - Saria Hassan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA; Department of Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Rakale Quarells
- Cardiovascular Research Institute, Morehouse School of Medicine, 720 Westview Drive, SW NCPC-318, Atlanta, GA 30310, USA
| | - Megha Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
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Campbell AD, Szaflarski M. Health programming priorities among faith communities in Jefferson County, Alabama. JOURNAL OF RELIGION & SPIRITUALITY IN SOCIAL WORK 2021; 40:371-394. [PMID: 35002549 PMCID: PMC8741115 DOI: 10.1080/15426432.2021.1907837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 03/20/2021] [Indexed: 06/14/2023]
Abstract
This paper details findings from interviews with 32 faith leaders regarding their interest in and preferences for collaborative health partnerships with an academic center. Participants were willing to partner to develop equitable, sustainable, and trust-based relationships for the purpose of meeting the health needs of their congregations. We also describe the planning and early development of faith community-academic partnership focused on providing information and resources aimed at improving health. We apply a framework incorporating a socioecological perspective and social capital theory to discuss how establishing linkages between clergy and academic researchers is a beneficial and important task for social work.
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Affiliation(s)
- Anthony D. Campbell
- Department of Sociology, Anthropology, and Social Work, Auburn University, Auburn, Alabama
| | - Magdalena Szaflarski
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama
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