1
|
Lalika M, McCoy CR, Jones C, Bancos I, Cooper LA, Hayes SN, Johnson MP, Kullo IJ, Kumbamu A, Noseworthy PA, Patten CA, Singh R, Wi CI, Brewer LC. Rationale, design, and participant characteristics of the FAITH! Heart Health+ study: An exploration of the influence of the social determinants of health, stress, and structural racism on African American cardiovascular health. Contemp Clin Trials 2024; 143:107600. [PMID: 38851481 DOI: 10.1016/j.cct.2024.107600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/16/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND African Americans (AAs) face cardiovascular health (CVH) disparities linked to systemic racism. The 2020 police killing of Mr. George Floyd in Minneapolis, Minnesota, alongside the COVID-19 pandemic, exacerbated adverse psychosocial factors affecting CVH outcomes among AAs. This manuscript describes the study protocol and participant characteristics in an ancillary study exploring the relationship between biopsychosocial factors and CVH among AAs. METHODS Using a community-based participatory approach, a mixed-methods ancillary study of 58 AA participants from an overarching randomized control trial (RCT) was conducted. Baseline RCT health assessments (November 2020) provided sociodemographic, medical, and clinical data. Subsequent health assessments (February-December 2022) measured sleep quality, psychosocial factors (e.g., high-effort coping), biomarkers (e.g., cortisol), and cardiovascular diagnostics (e.g., cardio-ankle vascular index). CVH was assessed using the American Heart Association Life's Simple 7 (LS7) (range 0 to 14, poor to ideal) and Life's Essential 8 (LE8) scores (range 0 to 100, low to high). Correlations between these scores will be examined. Focus group discussions via videoconferencing (March to April 2022) assessed psychosocial and structural barriers, along with the impact of COVID-19 and George Floyd's killing on daily life. RESULTS Participants were predominantly female (67%), with a mean age of 54.6 [11.9] years, high cardiometabolic risk (93% had overweight/obesity and 70% hypertension), and moderate LE8 scores (mean 57.4, SD 11.5). CONCLUSION This study will enhance understanding of the associations between biopsychosocial factors and CVH among AAs in Minnesota. Findings may inform risk estimation, patient care, and healthcare policies to address CVD disparities in marginalized populations.
Collapse
Affiliation(s)
- Mathias Lalika
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Carrie R McCoy
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Clarence Jones
- Hue-Man Partnership, 2400 Park Ave, Minneapolis, MN 55404, USA
| | - Irina Bancos
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Lisa A Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street, Suite#2-500, Baltimore, MD 21205, USA.
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Matthew P Johnson
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Iftikhar J Kullo
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Ashok Kumbamu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Peter A Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
| | - Ravinder Singh
- Division of Clinical Biochemistry & Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA; Center for Health Equity and Community Engagement Research, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| |
Collapse
|
2
|
Metzendorf MI, Wieland LS, Richter B. Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity. Cochrane Database Syst Rev 2024; 2:CD013591. [PMID: 38375882 PMCID: PMC10877670 DOI: 10.1002/14651858.cd013591.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Obesity is considered to be a risk factor for various diseases, and its incidence has tripled worldwide since 1975. In addition to potentially being at risk for adverse health outcomes, people with overweight or obesity are often stigmatised. Behaviour change interventions are increasingly delivered as mobile health (m-health) interventions, using smartphone apps and wearables. They are believed to support healthy behaviours at the individual level in a low-threshold manner. OBJECTIVES To assess the effects of integrated smartphone applications for adolescents and adults with overweight or obesity. SEARCH METHODS We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, and LILACS, as well as the trials registers ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform on 2 October 2023 (date of last search for all databases). We placed no restrictions on the language of publication. SELECTION CRITERIA Participants were adolescents and adults with overweight or obesity. Eligible interventions were integrated smartphone apps using at least two behaviour change techniques. The intervention could target physical activity, cardiorespiratory fitness, weight loss, healthy diet, or self-efficacy. Comparators included no or minimal intervention (NMI), a different smartphone app, personal coaching, or usual care. Eligible studies were randomised controlled trials of any duration with a follow-up of at least three months. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology and the RoB 2 tool. Important outcomes were physical activity, body mass index (BMI) and weight, health-related quality of life, self-efficacy, well-being, change in dietary behaviour, and adverse events. We focused on presenting studies with medium- (6 to < 12 months) and long-term (≥ 12 months) outcomes in our summary of findings table, following recommendations in the core outcome set for behavioural weight management interventions. MAIN RESULTS We included 18 studies with 2703 participants. Interventions lasted from 2 to 24 months. The mean BMI in adults ranged from 27 to 50, and the median BMI z-score in adolescents ranged from 2.2 to 2.5. Smartphone app versus no or minimal intervention Thirteen studies compared a smartphone app versus NMI in adults; no studies were available for adolescents. The comparator comprised minimal health advice, handouts, food diaries, smartphone apps unrelated to weight loss, and waiting list. Measures of physical activity: at 12 months' follow-up, a smartphone app compared to NMI probably reduces moderate to vigorous physical activity (MVPA) slightly (mean difference (MD) -28.9 min/week (95% confidence interval (CI) -85.9 to 28; 1 study, 650 participants; moderate-certainty evidence)). We are very uncertain about the results of estimated energy expenditure and cardiorespiratory fitness at eight months' follow-up. A smartphone app compared with NMI probably results in little to no difference in changes in total activity time at 12 months' follow-up and leisure time physical activity at 24 months' follow-up. Anthropometric measures: a smartphone app compared with NMI may reduce BMI (MD of BMI change -2.6 kg/m2, 95% CI -6 to 0.8; 2 studies, 146 participants; very low-certainty evidence) at six to eight months' follow-up, but the evidence is very uncertain. At 12 months' follow-up, a smartphone app probably resulted in little to no difference in BMI change (MD -0.1 kg/m2, 95% CI -0.4 to 0.3; 1 study; 650 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in body weight change (MD -2.5 kg, 95% CI -6.8 to 1.7; 3 studies, 1044 participants; low-certainty evidence) at 12 months' follow-up. At 24 months' follow-up, a smartphone app probably resulted in little to no difference in body weight change (MD 0.7 kg, 95% CI -1.2 to 2.6; 1 study, 245 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in self-efficacy for a physical activity score at eight months' follow-up, but the results are very uncertain. A smartphone app probably results in little to no difference in quality of life and well-being at 12 months (moderate-certainty evidence) and in little to no difference in various measures used to inform dietary behaviour at 12 and 24 months' follow-up. We are very uncertain about adverse events, which were only reported narratively in two studies (very low-certainty evidence). Smartphone app versus another smartphone app Two studies compared different versions of the same app in adults, showing no or minimal differences in outcomes. One study in adults compared two different apps (calorie counting versus ketogenic diet) and suggested a slight reduction in body weight at six months in favour of the ketogenic diet app. No studies were available for adolescents. Smartphone app versus personal coaching Only one study compared a smartphone app with personal coaching in adults, presenting data at three months. Two studies compared these interventions in adolescents. A smartphone app resulted in little to no difference in BMI z-score compared to personal coaching at six months' follow-up (MD 0, 95% CI -0.2 to 0.2; 1 study; 107 participants). Smartphone app versus usual care Only one study compared an app with usual care in adults but only reported data at three months on participant satisfaction. No studies were available for adolescents. We identified 34 ongoing studies. AUTHORS' CONCLUSIONS The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce for low- and middle-income countries as well as for people with different socio-economic and cultural backgrounds. The 34 ongoing studies suggest sustained interest in the topic, with new evidence expected to emerge within the next two years. In practice, clinicians and healthcare practitioners should carefully consider the potential benefits, limitations, and evolving research when recommending smartphone apps to adolescents and adults with overweight or obesity.
Collapse
Affiliation(s)
- Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bernd Richter
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
3
|
Golbus JR, Jeganathan VSE, Stevens R, Ekechukwu W, Farhan Z, Contreras R, Rao N, Trumpower B, Basu T, Luff E, Skolarus LE, Newman MW, Nallamothu BK, Dorsch MP. A Physical Activity and Diet Just-in-Time Adaptive Intervention to Reduce Blood Pressure: The myBPmyLife Study Rationale and Design. J Am Heart Assoc 2024; 13:e031234. [PMID: 38226507 PMCID: PMC10926831 DOI: 10.1161/jaha.123.031234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/13/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Smartphone applications and wearable devices are promising mobile health interventions for hypertension self-management. However, most mobile health interventions fail to use contextual data, potentially diminishing their impact. The myBPmyLife Study is a just-in-time adaptive intervention designed to promote personalized self-management for patients with hypertension. METHODS AND RESULTS The study is a 6-month prospective, randomized-controlled, remotely administered trial. Participants were recruited from the University of Michigan Health in Ann Arbor, Michigan or the Hamilton Community Health Network, a federally qualified health center network in Flint, Michigan. Participants were randomized to a mobile application with a just-in-time adaptive intervention promoting physical activity and lower-sodium food choices as well as weekly goal setting or usual care. The mobile study application encourages goal attainment through a central visualization displaying participants' progress toward their goals for physical activity and lower-sodium food choices. Participants in both groups are followed for up for 6 months with a primary end point of change in systolic blood pressure. Exploratory analyses will examine the impact of notifications on step count and self-reported lower-sodium food choices. The study launched on December 9, 2021, with 484 participants enrolled as of March 31, 2023. Enrollment of participants was completed on July 3, 2023. After 6 months of follow-up, it is expected that results will be available in the spring of 2024. CONCLUSIONS The myBPmyLife study is an innovative mobile health trial designed to evaluate the effects of a just-in-time adaptive intervention focused on improving physical activity and dietary sodium intake on blood pressure in diverse patients with hypertension. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT05154929.
Collapse
Affiliation(s)
- Jessica R. Golbus
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
- Michigan Integrated Center for Health Analytics and Medical PredictionUniversity of MichiganAnn ArborMIUSA
| | - V. Swetha E. Jeganathan
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Rachel Stevens
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Weena Ekechukwu
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Zahera Farhan
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Rocio Contreras
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Nikhila Rao
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Brad Trumpower
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Tanima Basu
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Evan Luff
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Lesli E. Skolarus
- Division of Vascular Neurology, Department of Neurology–Internal MedicineNorthwestern UniversityEvanstonILUSA
| | - Mark W. Newman
- School of Information and Computer Science, College of EngineeringUniversity of MichiganAnn ArborMIUSA
| | - Brahmajee K. Nallamothu
- Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA
- Michigan Integrated Center for Health Analytics and Medical PredictionUniversity of MichiganAnn ArborMIUSA
- The Center for Clinical Management and ResearchAnn ArborMIUSA
| | - Michael P. Dorsch
- Department of Clinical Pharmacy, College of PharmacyUniversity of MichiganAnn ArborMIUSA
| |
Collapse
|
4
|
Tadese K, Jenkins S, Aycock D, Jones C, Hayes SN, Burke LE, Cooper LA, Patten CA, Brewer LC. Factors Facilitating Academic-Community Research Partnerships With African American Churches: Recruitment Process for a Community-Based, Cluster Randomized Controlled Trial During the COVID-19 Pandemic. Health Promot Pract 2024; 25:8-12. [PMID: 36189723 DOI: 10.1177/15248399221118394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
African American (AA) churches are valuable partners in implementing health promotion programming (HPP) to combat health disparities. The study purpose was to evaluate AA church characteristics associated with enrollment into the FAITH! (Fostering African American Improvement in Total Health) Trial, a community-based, cluster randomized controlled trial (RCT) of a mobile health intervention for cardiovascular health promotion among AA churches. Churches located in Minneapolis-St. Paul and Rochester, Minnesota were invited to complete an electronic screening survey and follow-up telephone interview including the PREACH (Predicting Readiness to Engage African American Churches in Health) tool to assess church characteristics and infrastructure for HPP. The primary outcome was church enrollment in the FAITH! Trial. Key predictors included overall PREACH scores and its subscales (Personnel, Physical Structure, Faith-based Approach, Funding), congregation size, and mean congregation member age. Of the 26 churches screened, 16 (61.5%) enrolled in the trial. The enrolled churches had higher overall mean PREACH scores (36.1 vs. 30.2) and subscales for Personnel (8.8 vs. 5.6), Faith-based Approach (11.0 vs. 9.6), and Funding (7.3 vs. 4.8) compared with non-enrolled churches; all differences were not statistically significant due to small sample size. Twelve (75.0%) of the enrolled churches had >75 members versus six (60.0%) of the non-enrolled churches. Twelve (80.0%) of the enrolled churches had an average congregation member age ≤54 years versus six (67.0%) of the non-enrolled churches. AA churches enrolling into a community-based RCT reported greater infrastructure for HPP, larger congregations, and members of younger age. These characteristics may be helpful to consider among researchers partnering with AA churches for HPP studies.
Collapse
Affiliation(s)
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Lisa A Cooper
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Ezeh E, Ilonze O, Perdoncin M, Ramalingam A, Kaur G, Mustafa B, Teka S, Ferdinand KC. Life's essential eight as targets for cardiometabolic risk reduction among non-Hispanic black adults: A primary care approach. J Natl Med Assoc 2023:S0027-9684(23)00143-8. [PMID: 38142141 DOI: 10.1016/j.jnma.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/20/2023] [Indexed: 12/25/2023]
Abstract
Cardiovascular diseases remain the leading cause of death in the United States. Several studies have shown racial disparities in the cardiovascular outcomes. When compared to their Non-Hispanic White (NHW) counterparts, non-Hispanic Black (NHB) individuals have higher prevalence of cardiovascular risk factors and thus, increased mortality from atherosclerotic cardiovascular diseases. This is evidenced by lower scoring in the indices of the American Heart Association's Life Essential 8 among NHB individuals. NHB individuals score lower in blood pressure, blood lipids, nicotine exposure, sleep, physical activity level, glycemic control, weight, and diet when compared to NHW individuals. Measures to improve these indices at the primary care level may potentially hold the key in mitigating the health care disparities in cardiovascular health experienced by NHB individuals.
Collapse
Affiliation(s)
- Ebubechukwu Ezeh
- Department of Medicine, Marshall University, Huntington, WV, United States.
| | - Onyedika Ilonze
- Division of Cardiovascular Medicine, Indiana University School of Medicine, Indianapolis
| | - Maddie Perdoncin
- Department of Medicine, Marshall University, Huntington, WV, United States
| | - Archana Ramalingam
- Department of Medicine, Marshall University, Huntington, WV, United States
| | - Gurleen Kaur
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Bisher Mustafa
- Department of Medicine, Marshall University, Huntington, WV, United States
| | - Samson Teka
- Department of Medicine, Marshall University, Huntington, WV, United States
| | - Keith C Ferdinand
- John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States
| |
Collapse
|
7
|
Radu I, Scheermesser M, Spiess MR, Schulze C, Händler-Schuster D, Pehlke-Milde J. Digital Health for Migrants, Ethnic and Cultural Minorities and the Role of Participatory Development: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6962. [PMID: 37887700 PMCID: PMC10606156 DOI: 10.3390/ijerph20206962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
Digital health interventions (DHIs) are increasingly used to address the health of migrants and ethnic minorities, some of whom have reduced access to health services and worse health outcomes than majority populations. This study aims to give an overview of digital health interventions developed for ethnic or cultural minority and migrant populations, the health problems they address, their effectiveness at the individual level and the degree of participation of target populations during development. We used the methodological approach of the scoping review outlined by Tricco. We found a total of 2248 studies, of which 57 were included, mostly using mobile health technologies, followed by websites, informational videos, text messages and telehealth. Most interventions focused on illness self-management, mental health and wellbeing, followed by pregnancy and overall lifestyle habits. About half did not involve the target population in development and only a minority involved them consistently. The studies we found indicate that the increased involvement of the target population in the development of digital health tools leads to a greater acceptance of their use.
Collapse
Affiliation(s)
- Irina Radu
- Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
| | - Mandy Scheermesser
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
| | - Martina Rebekka Spiess
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland; (M.R.S.); (C.S.)
| | - Christina Schulze
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland; (M.R.S.); (C.S.)
| | - Daniela Händler-Schuster
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
- UMIT TIROL Institute for Nursing Science, Private University of Health Sciences and Health Technology, 6060 Hall in Tirol, Austria
- School of Nursing, Midwifery, and Health Practice, Faculty of Health, Victoria University of Wellington, Wellington 6012, New Zealand
| | - Jessica Pehlke-Milde
- Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland;
| |
Collapse
|
8
|
Brewer L, Jones C, Slusser J, Pasha M, Lalika M, Chacon M, Takawira P, Shanedling S, Erickson P, Woods C, Krogman A, Ferdinand D, Underwood P, Cooper L, Patten C, Hayes S. Mobile Health Intervention to Promote Hypertension Self-Management among African Americans Receiving Care at a Community Health Center: Formative Evaluation of the FAITH! Hypertension App. JMIR Form Res 2023. [PMID: 37115658 DOI: 10.2196/45061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND African Americans (AAs) are at a higher risk of premature death from cardiovascular diseases compared to White Americans, with disproportionate attributable risk from uncontrolled hypertension. These health disparities are rooted in structural racism with resultant adverse social determinants of health (SDOH) including limited access to quality healthcare. Given their high usage among AAs, mobile technologies, including smartphones, show promise in increasing access to reliable health information. Thus, culturally tailored mobile health (mHealth) interventions may promote hypertension self-management among this population. OBJECTIVE This formative study assessed the feasibility of integrating an innovative mHealth intervention into clinical and community settings to improve blood pressure (BP) control among AAs. METHODS A mixed methods study of AA patients with uncontrolled hypertension was implemented over two consecutive phases. In Phase 1, patients and clinicians from two federally qualified health centers (FQHCs) in the Minneapolis-St. Paul, Minnesota metropolitan area provided input through a focus group series to refine an existing culturally tailored mHealth app (FAITH! [Fostering African-American Improvement in Total Health!] App) to promote hypertension self-management among AA patients with uncontrolled hypertension. Phase 2 was a single-arm pre-post intervention pilot study to assess feasibility and patient satisfaction. Patients receiving care at an FQHC participated in a 10-week intervention utilizing the refined FAITH! Hypertension App synchronized with a wireless BP monitor and support from a community health worker (CHW) to address SDOH-related social needs. The multimedia app consisted of a 10-module educational series focused on hypertension and cardiovascular risk factors with interactive self-assessments, medication/BP self-monitoring and social networking. Primary outcomes were feasibility (app engagement/satisfaction) and preliminary efficacy (change in BP) at immediate post-intervention. RESULTS In Phase 1, 13 AA patients (69% age ≥50, 77% female) and 16 clinicians (69% age ≥50, 88% female, 63% AA) participated in focus groups. Based on their feedback, app modifications included addition of: BP/medications-tracking, BP self-care task reminders, and culturally sensitive contexts. In Phase 2, 16 AA patients were enrolled (mean age 52.6 years [SD 12.3], 75% female). Of the 16, 38% completed at least half of 10 education modules. Seven of the 16 completed the post-intervention assessment. These patients rated the intervention a 9 (out of 10) as helpful in hypertension self-management. Qualitative data revealed that these patients viewed the app as user-friendly, engaging, and informative, and CHWs were perceived as providing accountability and support. Of the 7 patients, mean systolic and diastolic BPs decreased by 6.4 mmHg (p=.15) and 2.8 mmHg (p=.78) at immediate post-intervention, respectively. CONCLUSIONS A culturally tailored mHealth app, with reinforcement by CHW support, may improve hypertension self-management among under-resourced AAs receiving care at FQHCs. A future randomized efficacy trial of the intervention is warranted. CLINICALTRIAL Registration: ClinicalTrials.gov Identifier: NCT03777709.
Collapse
Affiliation(s)
- LaPrincess Brewer
- Mayo Clinic College of Medicine, Department of Cardiovascular Medicine, 200 1st St S.W., Rochester, US
| | | | - Joshua Slusser
- Mayo Clinic, Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Rochester, US
| | | | - Mathias Lalika
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, US
| | - Megan Chacon
- Minnesota Department of Health, Heart Disease and Stroke Prevention Unit, St. Paul, US
| | - Patricia Takawira
- Minnesota Department of Health, Heart Disease and Stroke Prevention Unit, St. Paul, US
| | - Stanton Shanedling
- Minnesota Department of Health, Heart Disease and Stroke Prevention Unit, St. Paul, US
| | - Paul Erickson
- NorthPoint Health and Wellness Center, Minneapolis, US
| | | | - Ashton Krogman
- Mayo Clinic College of Medicine, Department of Cardiovascular Medicine, Rochester, US
| | - Daphne Ferdinand
- Healthy Heart Community Prevention Project, Inc., New Orleans, US
| | | | - Lisa Cooper
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, US
| | - Christi Patten
- Mayo Clinic College of Medicine, Department of Psychiatry and Psychology, Rochester, US
| | - Sharonne Hayes
- Mayo Clinic College of Medicine, Department of Cardiovascular Medicine, Rochester, US
| |
Collapse
|
9
|
Yan MZ, Yang M, Lai CL. Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis and Management. Viruses 2023; 15:v15020533. [PMID: 36851746 PMCID: PMC9964207 DOI: 10.3390/v15020533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved through history and symptomatology that cannot be explained by an alternative diagnosis. However, the heavy reliance on subjective reporting is prone to reporting errors. Besides, there is no unified diagnostic assessment tool to classify the clinical severity of patients. This leads to significant difficulties when managing patients in terms of public resource utilization, clinical progression monitorization and rehabilitation plan formulation. This narrative review aims to review current evidence of diagnosis based on triple assessment: clinical symptomatology, biochemical analysis and imaging evidence. Further assessment tools can be developed based on triple assessment to monitor patient's clinical progression, prognosis and intervals of monitoring. It also highlights the high-risk features of patients for closer and earlier monitoring. Rehabilitation programs and related clinical trials are evaluated; however, most of them focus on cardiorespiratory fitness and psychiatric presentations such as anxiety and depression. Further research is required to establish an objective and comprehensive assessment tool to facilitate clinical management and rehabilitation plans.
Collapse
Affiliation(s)
- Michael Zhipeng Yan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
- Correspondence: (M.Z.Y.); (C.-L.L.)
| | - Ming Yang
- Department of Ophthalmology, The University of Hong Kong, Hong Kong SAR, China
| | - Ching-Lung Lai
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
- Correspondence: (M.Z.Y.); (C.-L.L.)
| |
Collapse
|
10
|
Commodore-Mensah Y, Metlock FE, Cooper LA. Rethinking, Reimagining, and Reigniting Community-Engaged Research to Promote Cardiovascular Health Equity. Circ Cardiovasc Qual Outcomes 2022; 15:e009519. [PMID: 36378771 PMCID: PMC9716750 DOI: 10.1161/circoutcomes.122.009519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yvonne Commodore-Mensah
- Associate Professor, Johns Hopkins School of Nursing and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.C.M.)
| | | | - Lisa A Cooper
- Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins School of Nursing, Baltimore, MD (L.A.C.)
| |
Collapse
|
11
|
Joseph JJ, Rajwani A, Roper D, Zhao S, Kline D, Odei J, Brock G, Echouffo-Tcheugui JB, Kalyani RR, Bertoni AG, Effoe VS, Sims M, Wu WC, Wand GS, Golden SH. Associations of Cardiometabolic Multimorbidity With All-Cause and Coronary Heart Disease Mortality Among Black Adults in the Jackson Heart Study. JAMA Netw Open 2022; 5:e2238361. [PMID: 36282500 PMCID: PMC9597394 DOI: 10.1001/jamanetworkopen.2022.38361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE A combination of diabetes, coronary heart disease (CHD), and stroke has multiplicative all-cause mortality risk compared with any individual morbidity in White populations, but there is a lack of studies in Black populations in the US. OBJECTIVE To examine the association of cardiometabolic multimorbidity (diabetes, stroke, and CHD) individually and collectively with all-cause and CHD mortality. DESIGN, SETTING, AND PARTICIPANTS This cohort study included Black adults in the Jackson Heart Study followed over a median of 15 years. Baseline examinations were performed between 2000 and 2004, with follow-up on all-cause and CHD mortality through May 31, 2018. Participants were categorized into mutually exclusive groups at baseline: (1) free of cardiometabolic morbidity, (2) diabetes, (3) CHD, (4) stroke, (5) diabetes and stroke, (6) CHD and stroke, (7) diabetes and CHD, and (8) diabetes, stroke, and CHD. Data were analyzed from 2019 to 2021. EXPOSURE Cardiometabolic disease alone or in combination. MAIN OUTCOMES AND MEASURES The main outcomes were all-cause mortality and CHD mortality. Cox models estimated hazard ratios (HRs) with 95% CIs adjusted for sociodemographic and cardiovascular risk factors. RESULTS Among 5064 participants (mean [SD] age, 55.4 [12.8] years; 3200 [63%] women) in the Jackson Heart Study, 897 (18%) had diabetes, 192 (4%) had CHD, and 104 (2%) had a history of stroke. Among participants with cardiometabolic morbidities, the crude all-cause mortality rates were lowest for diabetes alone (24.4 deaths per 1000 person-years) and highest for diabetes, CHD, and stroke combined (84.1 deaths per 1000 person-years). For people with only 1 cardiometabolic morbidity, risk for all-cause mortality was highest for people with stroke (HR, 1.74; 95% CI, 1.24-2.42), followed by CHD (HR, 1.59 (95% CI, 1.22-2.08) and diabetes (HR, 1.50; 95% CI, 1.22-1.85), compared with no cardiometabolic morbidities. There were also increased risks of mortality with combinations of diabetes and stroke (HR, 1.71; 95% CI, 1.09-2.68), CHD and stroke (HR, 2.23; 95% CI, 1.35-3.69), and diabetes and CHD (HR, 2.28; 95% CI, 1.65-3.15). The combination of diabetes, stroke, and CHD was associated with the highest all-cause mortality (HR, 3.68; 95% CI, 1.96-6.93). Findings were similar for CHD mortality, but with a larger magnitude of association (eg, diabetes, stroke, and CHD: HR, 13.52; 95% CI, 3.38-54.12). CONCLUSIONS AND RELEVANCE In this cohort study, an increasing number of cardiometabolic multimorbidities was associated with a multiplicative increase in risk of all-cause mortality among Black adults, with a greater magnitude of association for CHD mortality.
Collapse
Affiliation(s)
- Joshua J. Joseph
- Department of Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Aakash Rajwani
- Department of Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Daniel Roper
- Department of Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Songzhu Zhao
- Department of Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - David Kline
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - James Odei
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus
| | - Guy Brock
- Department of Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Justin B. Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Massachusetts
| | - Rita R. Kalyani
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Massachusetts
| | - Alain G. Bertoni
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Valery S. Effoe
- Department of Internal Medicine, Morehouse School of Medicine, Atlanta, Georgia
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Wen-Chi Wu
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Gary S. Wand
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Massachusetts
| | - Sherita H. Golden
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Massachusetts
| |
Collapse
|
12
|
A Systematic Review of Internet-Based Interventions for the Prevention and Self-Management of Cardiovascular Diseases among People of African Descent. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148872. [PMID: 35886719 PMCID: PMC9319273 DOI: 10.3390/ijerph19148872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022]
Abstract
Cardiovascular disease (CVD) risk factors, morbidity, and mortality among people of African descent (PAD) appear to be higher than in the general population. While it has been found that lifestyle changes can prevent around 90% of CVDs, implementing an effective lifestyle programme is expensive and time-consuming. It has been demonstrated that Internet-based interventions (IbIs) can effectively and inexpensively encourage lifestyle modifications to prevent and manage chronic diseases. Although a number of studies have examined the effectiveness of IbIs in the general population, no comprehensive study of the usefulness and acceptability of IbIs among PAD has been conducted. This is the knowledge gap that this study aimed to address. We searched MEDLINE, EMBASE, CINAHL, and Web of Science to identify eligible studies published from inception to February 2022. Thirteen articles met our criteria for inclusion. Our textual narrative synthesis produced inconsistent results; nonetheless, high acceptability of IbIs and a considerable improvement in clinical and behavioural outcomes associated with CVDs were reported in several trials. The findings of this review are constrained by clinical, methodological and statistical variability among the studies. To have a good grasp on the effect of IbIs on behaviour change in PAD at risk of CVDs, large-scale longitudinal studies with long-term follow-up are required.
Collapse
|
13
|
Brewer LC, Jenkins S, Hayes SN, Kumbamu A, Jones C, Burke LE, Cooper LA, Patten CA. Community-Based, Cluster-Randomized Pilot Trial of a Cardiovascular Mobile Health Intervention: Preliminary Findings of the FAITH! Trial. Circulation 2022; 146:175-190. [PMID: 35861762 PMCID: PMC9287100 DOI: 10.1161/circulationaha.122.059046] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND African Americans continue to have suboptimal cardiovascular health (CVH) based on the American Heart Association Life's Simple 7 (LS7), 7 health-promoting behaviors and biological risk factors (eg, physical activity, blood pressure). Innovative, community-level interventions in partnership with trusted institutions such as African American churches are potential means to improve CVH in this population. METHODS Using a community-based participatory research approach, the FAITH! Trial (Fostering African American Improvement in Total Health) rigorously assessed the feasibility and preliminary efficacy of a refined, community-informed, mobile health intervention (FAITH! App) for promoting CVH among African Americans in faith communities using a cluster randomized controlled trial. Participants from 16 churches in Rochester and Minneapolis-St Paul, MN, were randomized to receive the FAITH! App (immediate intervention) or were assigned to a delayed intervention comparator group. The 10-week intervention core features included culturally relevant and LS7-focused education modules, diet/physical activity self-monitoring, and a group sharing board. Data were collected via electronic surveys and health assessments. Primary outcomes were average change in mean LS7 score (continuous measure of CVH ranging from poor to ideal [0-14 points]) from baseline to 6 months post-intervention (using generalized estimating equations) and app engagement/usability (by the Health Information Technology Usability Evaluation Scale; range, 0-5). RESULTS Of 85 enrolled participants (randomized to immediate [N=41] and delayed [control] intervention [N=44] groups), 76 and 68 completed surveys/health assessments at baseline and 6 months post-intervention, respectively (80% retention rate with assessments at both baseline and 6-month time points); immediate intervention [N=30] and control [N=38] groups). At baseline, the majority of participants (mean age [SD], 54.2 [12.3] years, 71% female) had <4-year college education level (39/66, 59%) and poor CVH (44% in poor category; mean LS7 score [SD], 6.8 [1.9]). The mean LS7 score of the intervention group increased by 1.9 (SD 1.9) points compared with 0.7 (SD 1.7) point in the control group (both P<0.0001) at 6 months. The estimated difference of this increase between the groups was 1.1 (95% CI, 0.6-1.7; P<0.0001). App engagement/usability was overall high (100% connection to app; >75% completed weekly diet/physical activity tracking; Health Information Technology Usability Evaluation Scale, mean [SD], 4.2 [0.7]). CONCLUSIONS On the basis of preliminary findings, the refined FAITH! App appears to be an efficacious mobile health tool to promote ideal CVH among African Americans. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03777709.
Collapse
Affiliation(s)
- LaPrincess C. Brewer
- Department of Cardiovascular Medicine (L.C.B., S.N.H.), Mayo Clinic College of Medicine, Rochester, MN
- Center for Health Equity and Community Engagement Research (L.C.B.), Mayo Clinic, Rochester, MN
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences (S.J.), Mayo Clinic, Rochester, MN
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine (L.C.B., S.N.H.), Mayo Clinic College of Medicine, Rochester, MN
| | - Ashok Kumbamu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (A.K.), Mayo Clinic, Rochester, MN
| | | | - Lora E. Burke
- School of Nursing, Department of Health and Community Systems, University of Pittsburgh, PA (L.E.B.)
| | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (L.A.C.)
| | - Christi A. Patten
- Department of Psychiatry and Psychology (C.A.P.), Mayo Clinic College of Medicine, Rochester, MN
| |
Collapse
|
14
|
Brewer LC, Cyriac J, Kumbamu A, Burke LE, Jenkins S, Hayes SN, Jones C, Cooper LA, Patten CA. Sign of the times: Community engagement to refine a cardiovascular mHealth intervention through a virtual focus group series during the COVID-19 Pandemic. Digit Health 2022; 8:20552076221110537. [PMID: 35874864 PMCID: PMC9297470 DOI: 10.1177/20552076221110537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background African-Americans are underrepresented in mobile health intervention research studies which can perpetuate health inequities and the digital divide. A community-based, user-centered approach to designing mobile health interventions may increase their sociocultural relevance and effectiveness, especially with increased smartphone use during the coronavirus disease 2019 pandemic. We aimed to refine an existing mobile health intervention via a virtual focus group series. Methods African-American community members (n = 15) from churches in Minneapolis-St. Paul and Rochester, Minnesota were enrolled in a virtual (via videoconferencing), three-session focus group series over five months to refine a cardiovascular health-focused mobile health application (FAITH! [Fostering African-American Improvement in Total Health!] App). Participants accessed the app via their smartphones and received a Fitbit synced to the app. Participants engaged with multimedia cardiovascular health-focused education modules, a sharing board for social networking, and diet/physical activity self-monitoring. Participant feedback on app features prompted iterative revisions to the FAITH! App. Primary outcomes were app usability (assessed via Health Information Technology Usability Evaluation Scale range: 0–5) and user satisfaction. Results Participants (mean age [SD]: 56.9 [12.3] years, 86.7% female) attended a mean 2.8 focus groups (80% attended all sessions). The revised FAITH! App exceeded the goal Health Information Technology Usability Evaluation Scale score threshold of ≥4 (mean: 4.39, range: 3.20–4.95). Participants positively rated updated app content, visual appeal, and use of social incentives to maintain engagement. Increasing user control and refinement of the moderated sharing board were identified as areas for future improvement. Conclusions Community-partnered, virtual focus groups can optimize usability and increase participant satisfaction of mobile health lifestyle interventions that aim to promote cardiovascular health in African-Americans.
Collapse
Affiliation(s)
- LaPrincess C. Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
| | - Jissy Cyriac
- Department of Internal Medicine, Mayo Clinic Graduate School of Medical Education, Rochester, MN, USA
| | - Ashok Kumbamu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Lora E. Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sarah Jenkins
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christi A. Patten
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| |
Collapse
|