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Clark EM, Ma L, Rigdon SE, Williams BR, Park CL, Ghosh D, Woodard N, Knott CL. Identifying Variation in Physical Health Behaviors and Depressive Symptoms among Religiosity Clusters of African American Adults in the United States. JOURNAL OF RELIGION AND HEALTH 2024; 63:3027-3049. [PMID: 38970680 DOI: 10.1007/s10943-024-02074-9] [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: 06/04/2024] [Indexed: 07/08/2024]
Abstract
Religiosity is an important factor in the lives of many African Americans, who suffer a greater health burden than their White counterparts. In this study, we examined associations between dimensions of religiosity with health behaviors and depressive symptoms in a sample of African American adults in the United States. Participants (N = 2086) completed five measures of religiosity (religious involvement, positive and negative religious coping, scriptural influence, belief in illness as punishment for sin) and measures of several health behaviors, cancer screening behaviors, and depressive symptoms. Using cluster analysis to examine the deep structure of religiosity, three clusters emerged: Positive Religious, Negative Religious, and Low Religious. In general, the Positive Religious group engaged in more healthy behaviors (e.g., fruit and vegetable consumption, fecal occult blood test) and fewer risky health behaviors (e.g., smoke and consume alcohol), and reported fewer depressive symptoms than did the Negative Religious and/or Low Religious groups. Theoretical implications and implications for interventions by clergy and mental health professionals are discussed.
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Affiliation(s)
- Eddie M Clark
- Department of Psychology, Saint Louis University, Morrissey Hall, 3700 Lindell Blvd., St. Louis, MO, 63108, USA.
| | - Lijing Ma
- Department of Psychology, University of San Francisco, San Francisco, CA, USA
| | - Steven E Rigdon
- Department of Epidemiology and Biostatistics, Saint Louis University, St. Louis, MO, USA
| | - Beverly R Williams
- Division of Gerontology, Geriatrics, and Palliative Care of the Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut - Storrs, Storrs, CT, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut - Storrs, Storrs, CT, USA
| | - Nathaniel Woodard
- Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
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Obeng-Nyarko CN, Ralston PA, Wickrama KKAS, Lemacks JL, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Perceived Stress and Allostatic Load Outcomes of Mid-Life and Older African American Women. HEALTH EDUCATION & BEHAVIOR 2024:10901981241263027. [PMID: 39051464 DOI: 10.1177/10901981241263027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States, with African Americans experiencing higher age-adjusted mortality compared to Whites. African American women in particular carry a high CVD burden due to more exposure to adverse personal and socioenvironmental challenges. Church-based interventions can improve health behaviors and health status of African Americans, yet few have addressed stress-related health. The purpose of this study was to determine the effectiveness of the 18-month Health for Hearts United intervention in relation to stress-related outcomes (perceived stress, allostatic load) of mid-life and older African American women (≥45 years of age; n = 152 overall sample, n = 65 clinical subsample). The results of the repeated measures analysis of variance (ANOVA) analyses showed overall significant decreases in perceived stress and allostatic load for both treatment and comparison groups over the measurement occasions (baseline and 18 months) with educational level remaining as a significant correlate over time. There was no significant interaction between treatment and time, yet there were trends in improvements for the treatment group compared to the comparison group. The findings demonstrate the potential of church-based interventions in reducing both self-reported stress and allostatic load in African American women, and highlight the need for further investigation of educational level and other possible factors influencing stress management in these settings.
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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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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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Yang J, Park B. A scoping review key elements and effects of cardiovascular disease management programs based on community-based participatory research. PLoS One 2023; 18:e0279563. [PMID: 36662793 PMCID: PMC9858102 DOI: 10.1371/journal.pone.0279563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 12/09/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This scoping review analyses the literature on community-based participatory research (CBPR)-based cardiovascular disease (CVD) management programmes, examining the key elements of their development and implementation and exploring their effectiveness. METHODS This scoping review's methodology had six stages: 1) identifying the research question; 2) identifying relevant studies-search strategy; 3) study selection; 4) charting the data; 5) collating, summarising, and reporting the results; and 6) consultation exercise. The databases used were PubMed, Cochrane, and CINAHL, for the period from 4 March to 3 April 2022. We selected studies 1) published after 2000; 2) targeting community residents over 18 years old; and 3) proposed a CBPR-based CVD management programme, described its development, and evaluated its effects based on its application. Data were extracted independently by each of the two researchers, using a standardised form. RESULTS Among the key aspects of such programmes were the many cases where community organisations led establishment of partnerships and cases where a decision-making committee was formed. Regarding application of the CBPR principles, community partners participated only in executing the research, not in analysing and interpreting research results. In addition, among the 21 studies selected were 6 randomised controlled trials, all of which showed a significant positive effect in experimental groups compared to control groups. CONCLUSION Improvement strategies are needed to allow implementation of CBPR principles in a CBPR-based CVD management programme. Moreover, further verification of programme evaluation research methods is needed. SCOPING REVIEW REGISTRATION This protocol has been registered to the OSF registries. 0000000204460911. Key Elements and Effects of Cardiovascular Disease Management Programs Based on Community-based Participatory Research: Protocol for a Scoping Review'. OSF, 4 Sept. 2020. Web.
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Affiliation(s)
- Juhyeon Yang
- Department of Nursing, Changwon National University, Changwon, Gyeongnam, Republic of Korea
| | - Bohyun Park
- Department of Nursing, Changwon National University, Changwon, Gyeongnam, Republic of Korea
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Ralston PA, Young-Clark I, Wickrama K(A, Coccia C, Lemacks JL, Battle AM, Hart C, Ilich JZ. Dissemination trial for Health for Hearts United: Model development, preliminary outcomes and lessons learned. Contemp Clin Trials Commun 2022; 29:100979. [PMID: 36052174 PMCID: PMC9424356 DOI: 10.1016/j.conctc.2022.100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cardiovascular disease CVD), the leading cause of death in the U.S., is a particular problem for African Americans (AAs). Church-based health interventions are effective in reducing CVD risk, yet few have been successfully disseminated. This paper describes the model development, preliminary health outcomes, and lessons learned from the Health for Hearts United (HHU) dissemination trial which evolved from the longitudinal Reducing CVD Risk Study in a two-county area in North Florida. Community-based participatory research approaches and the socio-ecological model guided the study. Methods Data for this paper were from health leaders (n = 25) in the first six churches investigated, and the outreach participants (n = 86) they engaged. Health leaders completed survey items (daily servings of fruits/vegetables [F/V], fat consumption [FAT], and daily minutes of physical activity [PA]) and clinical measures (body mass index [BMI]; waist, hip and abdomen circumferences; and systolic and diastolic blood pressure [BP]). For outreach participants, a brief CVD Awareness Quiz was administered. Data were analyzed using description statistics, Pearson correlations, and repeated measures analysis of variance. Results Findings showed that the dissemination model was implemented by 100% of the churches, and resulted in health outcomes changes for health leaders (significant increases between pre- and post-test in F/V; significant decreases in FAT, BMI, abdomen circumference, with educational level and marital status as selected significant covariates) and in a significant increase in CVD awareness for outreach participants. Lessons learned are discussed. Although preliminary, the results suggest that the HHU dissemination model has promise for reducing CVD risk in AA's.
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Affiliation(s)
- Penny A. Ralston
- , Center on Better Health and Life for Underserved Populations, Florida State University, P.O. Box 3064191, Tallahassee, FL, 32306-1491, USA
| | - Iris Young-Clark
- , Center on Better Health and Life for Underserved Populations, Florida State University, USA
| | - Kandauda (A.S.) Wickrama
- Georgia Athletic Association Endowed Professor of Human Development and Family Science Research, University of Georgia, USA
| | - Catherine Coccia
- , Department of Dietetics & Nutrition, Florida International University, USA
| | - Jennifer L. Lemacks
- College of Nursing and Health Professions, University of Southern Mississippi, USA
| | | | | | - Jasminka Z. Ilich
- , Institute for Successful Longevity, Consulting Faculty, Center on Better Health and Life for Underserved Populations, Florida State University, USA
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Wickrama KAS, Ralston PA. Religiosity and Physical Health of Middle–Old Aged African Americans: The Linking Role of Self-Control. J Aging Health 2022; 35:311-324. [PMID: 36154500 DOI: 10.1177/08982643221128653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study examined a psychological process (i.e., sense of control) that links religiosity to self-reported physical health in older African Americans. Methods: Two waves of data from 231 middle–old aged African Americans (AAs) were used to test two specific hypotheses: (a) religiosity influences changes in sense of control middle–old aged AAs, and (b) sense of control influences changes in global physical health in middle–old aged AAs. The analysis used two modeling approaches: (a) an autoregressive cross-lagged modeland (b) a parallel growth/change model. Results: The results of both types of models showed that religiosity positively influenced changes in sense of control and that sense of control positively influenced changes in physical health in middle–old aged AAs over time. Discussion: These findings provide evidence that sense of control links religiosity to physical health in older African Americans. The theoretical and practical implications of the findings are discussed.
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Affiliation(s)
| | - Penny A. Ralston
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, FL, USA
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Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation 2022; 146:e18-e43. [PMID: 35766027 PMCID: PMC10503546 DOI: 10.1161/cir.0000000000001078] [Citation(s) in RCA: 704] [Impact Index Per Article: 352.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life's Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life's Essential 8. The components of Life's Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.
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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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Caffo O, Ralston PA, Lemacks JL, Young-Clark I, Wickrama KKAS, Ilich JZ. Sex and Body Circumferences Associated with Serum Leptin in African American Adults. J Womens Health (Larchmt) 2021; 30:1769-1777. [PMID: 33661054 DOI: 10.1089/jwh.2020.8820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective: Cardiovascular disease (CVD) continues to be a leading cause of death for U.S. adults, especially African Americans (AA). Yet, few studies have examined a comprehensive set of metabolic health and health behavior factors related to CVD risk in this population. This study investigated the relationship between serum leptin and anthropometries (body mass index [BMI], circumferences [waist-WC, hip-HC, and waist/hip ratio W/H]), metabolic health (systolic and diastolic blood pressure [BP], serum lipids, glucose, and C-reactive protein [CRP]), and health behaviors (hours of sleep, physical activity) in midlife and older AAs. Materials and Methods: Participants (n = 89, ≥45 years of age) were AAs in six churches in North Florida enrolled in a broader church-based longitudinal study. Anthropometric measurements, serum analyses, and self-reported items. Results: Serum leptin was positively correlated with gender (being female) (r = 0.623, p < 0.001), BMI log transformed (r = 0.469, p < 0.001), WC (r = 0.440, p < 0.001), HC (r = 0.658, p < 0.001), use of BP medication (r = 0.216, p < 0.05), and serum CRP (r = 0.277, p < 0.01). Correlations by sex showed significant relationships for both men and women between leptin and BMI log transformed, WC, and HC. The final multiple regression model [R2 = 0.758, F(4, 66) = 55.871, p < 0.001] showed that 75.8% of the variance in leptin was explained by being female (β = 0.65, p < 0.001), WC (β = 0.26, p < 0.02), and HC (β = 0.28, p < 0.01). Conclusions: Findings more specifically delineate the variables associated with serum leptin in AAs, particularly WC and HC, and suggest greater attention to possible risk for leptin resistance in AA females. Clinical Trial Registration: This study is registered at www.clinicaltrials.gov NCT03339050.
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Affiliation(s)
- Olenka Caffo
- College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Penny A Ralston
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida, USA
| | - Jennifer L Lemacks
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Iris Young-Clark
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida, USA
| | | | - Jasminka Z Ilich
- Institute for Successful Longevity, Consulting Faculty, Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida, USA
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