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Community-based, cluster-randomized pilot trial of a cardiovascular mHealth intervention: Rationale, design, and baseline findings of the FAITH! Trial. Am Heart J 2022; 247:1-14. [PMID: 35065922 PMCID: PMC9037298 DOI: 10.1016/j.ahj.2022.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Compared to whites, African-Americans have lower prevalence of ideal cardiovascular health (CVH) based on the American Heart Association Life's Simple 7 (LS7). These CVH inequities have worsened during the COVID-19 pandemic. Ideal LS7 health-promoting behaviors and biological risk factors (eg, diet, blood pressure) are associated with improved CVH outcomes. The FAITH! (Fostering African-American Improvement in Total Health) App, a community-informed, mobile health (mHealth) intervention, previously demonstrated significant improvements in LS7 components among African-Americans, suggesting that mHealth interventions may be effective in improving CVH. This paper presents the FAITH! Trial design, baseline findings, and pandemic-related lessons learned. METHODS Utilizing a community-based participatory research approach, this study assessed the feasibility/preliminary efficacy of a refined FAITH! App for promoting LS7 among African-Americans in faith communities using a cluster, randomized controlled trial. Participants received the FAITH! App (immediate intervention) or were assigned to a delayed intervention comparator group. Baseline data were collected via electronic surveys and health assessments. Primary outcomes are change in LS7 score from baseline to 6-months post-intervention and app engagement/usability. RESULTS Of 85 enrolled individuals, 76 completed baseline surveys/health assessments, for a participation rate of 89% (N = 34 randomized to the immediate intervention, N = 42 to delayed intervention). At baseline, participants were predominantly female (54/76, 71%), employed (56/76, 78%) and of high cardiometabolic risk (72/76, 95% with hypertension and/or overweight/obesity) with mean LS7 scores in the poor range (6.8, SD = 1.9). CONCLUSIONS The FAITH! Trial recruitment was feasible, and its results may inform the use of mHealth tools to increase ideal CVH among African-Americans.
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Mansfield LN, Nagy GA, Solorzano R, Carreño M, Mercado Emerson M, Solis Guzman ML, Gonzalez-Guarda RM. Targeted Strategies for Recruitment and Engagement of Latinx Immigrants in Longitudinal Biobehavioral Research. HISPANIC HEALTH CARE INTERNATIONAL 2022; 21:68-77. [PMID: 35238247 DOI: 10.1177/15404153221083659] [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: 11/16/2022]
Abstract
Introduction: Racial/ethnic minority communities are underrepresented in research. Medical mistrust and mistreatment, discrimination, and a lack of diverse research workforce may influence recruitment and engagement. Engaging Latinx immigrants for research presents unique recruitment challenges, especially for biobehavioral research which is not well explored. The purpose of this paper is to examine the effect of targeted strategies for recruiting young adult, Latinx immigrants. Methods: Recruitment occurred from 2018 to 2019 in an ongoing, longitudinal, community-engaged research study examining risk and resilience factors for health outcomes in Latinx immigrants. Strategies included active recruitment (e.g., community-based events and public events) and passive recruitment (e.g., word-of-mouth and radio and flyer advertisements). Logistic regression analysis was conducted to examine the influence of type of recruitment on participant enrollment. Results: The study enrolled 391 participants of 701 interested individuals (55%). Greater odds of enrollment were among participants recruited through radio and flyer advertisements (adjusted odds ratio [AOR]=2.90, 95%CI [1.59, 5.27], p=.001), word-of-mouth (AOR=2.50, 95% CI [1.55, 4.03], p<.000), or community-based organization events (AOR=1.68, 95% CI [1.19, 2.38], p=.003). Conclusions: Passive recruitment strategies through trusted sources increased the odds of enrollment of Latinx immigrants in biobehavioral research. Future recruitment efforts should leverage trusted sources to disseminate recruitment materials addressing barriers to recruiting Latinx participants for research.
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Affiliation(s)
- Lisa N Mansfield
- Department of Medicine, Division of General Internal Medicine & Health Services Research, 8783University of California, Los Angeles, CA, USA.,15776Duke University School of Nursing, Durham, NC, USA
| | - Gabriela A Nagy
- 15776Duke University School of Nursing, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, 12277Duke University School of Medicine, Durham, NC, USA
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Casillas A, Rosas LG, Carson SL, Orechwa A, North G, AuYoung M, Kim G, Guereca JA, Ramers CB, Burke NJ, Corchado CG, Aguilar-Gaxiola S, Cheney A, Rabin BA, Stadnick NA, Oswald W, Cabrera A, Sorkin DH, Zaldivar F, Wong W, Yerraguntala AS, Vassar SD, Wright AL, Washington DL, Norris KC, Brown AF. STOP COVID-19 CA: Community engagement to address the disparate impacts of the COVID-19 pandemic in California. FRONTIERS IN HEALTH SERVICES 2022; 2:935297. [PMID: 36925779 PMCID: PMC10012632 DOI: 10.3389/frhs.2022.935297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/10/2022] [Indexed: 12/03/2022]
Abstract
Objective To describe the early activities and lessons of the Share, Trust, Organize, Partner COVID-19 California Alliance (STOP COVID-19 CA), the California awardee of the NIH-funded multi-state Community Engagement Alliance (CEAL) against COVID-19. The Alliance was established to ensure equity in Coronavirus-19 disease (COVID-19) research, clinical practice, and public health for communities most impacted by the COVID-19 pandemic. Study setting The STOP COVID-19 CA Alliance network of 11 universities and affiliated partner community-based organizations (CBOs) across California. Study design Mixed methods evaluation consisting of an analysis of activity (August 2020 to December 2021) detailed in reports submitted by community-academic teams and a survey (August 2021) of academic investigators and affiliated community-based organization (CBO) partners. Data collection We summarized activities from the 11 community-academic teams' progress reports and described results from an online survey of academic investigators and CBO partners in the California Alliance. Principal findings A review of progress reports (n = 256) showed that teams fielded surveys to 11,000 Californians, conducted 133 focus groups, partnered with 29 vaccine/therapeutics clinical trials, and led more than 300 town halls and vaccine events that reached Californians from communities disproportionately impacted by COVID-19. Survey responses from academic investigators and CBO partners emphasized the importance of learning from the successes and challenges of the California Alliance teams' COVID-19 initiatives. Both academic and CBO respondents highlighted the need for streamlined federal and institutional administrative policies, and fiscal practices to promote more effective and timely operations of teams in their efforts to address the numerous underlying health and social disparities that predispose their communities to higher rates of, and poor outcomes from, COVID-19. Conclusions STOP COVID-19 CA represents a new and potentially sustainable statewide community engagement model for addressing health disparities in multiethnic/multicultural and geographically dispersed communities.
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Affiliation(s)
- Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, United States.,Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine, Stanford, CA, United States
| | - Savanna L Carson
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Allison Orechwa
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Gemma North
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | | | - Gloria Kim
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Jesus A Guereca
- Laura Rodriguez Research Institute Family Health Centers of San Diego, San Diego, CA, United States
| | - Christian B Ramers
- Division of Infectious Diseases, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Nancy J Burke
- Public Health Department, University of California, Merced, Merced, CA, United States
| | | | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities and Community Engagement Program of the Clinical and Translational Science Center, Department of Internal Medicine, University of California, Davis, Sacramento, CA, United States
| | - Ann Cheney
- Department of Social Medicine Population and Public Health, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Borsika A Rabin
- UC San Diego Altman Clinical Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, United States.,Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Nicole A Stadnick
- UC San Diego Altman Clinical Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States.,Child and Adolescent Services Research Center, San Diego, CA, United States
| | - William Oswald
- The Global Action Research Center, San Diego, CA, United States
| | - Abby Cabrera
- Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Dara H Sorkin
- Department of Medicine, Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, United States
| | - Frank Zaldivar
- Department of Pediatrics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, United States
| | - Wennie Wong
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Anusha S Yerraguntala
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Stefanie D Vassar
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Aziza Lucas Wright
- Department of Preventive and Social Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.,South Central Prevention Coalition, Los Angeles, CA, United States
| | - Donna L Washington
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States.,VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Keith C Norris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Arleen F Brown
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States.,Olive View Medical Center, Los Angeles County Department of Health Services, Sylmar, CA, United States
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Jose T, Warner DO, O'Horo JC, Peters SG, Chaudhry R, Binnicker MJ, Burger CD. Digital Health Surveillance Strategies for Management of Coronavirus Disease 2019. Mayo Clin Proc Innov Qual Outcomes 2020; 5:109-117. [PMID: 33521582 PMCID: PMC7831529 DOI: 10.1016/j.mayocpiqo.2020.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective To describe the design, implementation, and utilization of electronic health record (EHR)-based digital health surveillance strategies used to manage the coronavirus disease 2019 (COVID-19) pandemic and to ensure delivery of high-quality clinical care, such as case identification, remote monitoring, telemedicine services, and recruitment to clinical trials at Mayo Clinic. Methods The design and implementation work described in this report was performed at Mayo Clinic, a large multistate integrated health care system with more than 1.5 million annual patient visits that uses the Epic EHR system. Rule-based live registries were designed in the EHR system to classify patients who currently test positive for COVID-19, patients who test positive but have recovered from COVID-19, patients who are thought to have COVID-19 but do not yet meet clinical diagnostic criteria, patients who test negative for COVID-19, and patients who exceed a risk score for serious complications from COVID-19. Results By use of registries, custom dashboards and operational reports were developed to provide a daily high-level summary for clinical practice use and up-to-date information to manage individual patients affected by COVID-19, including support of case identification, contact isolation, and other care management tasks. Conclusion We developed and implemented a systematic approach to the use of EHR patient registries to manage the COVID-19 pandemic that proved feasible and useful in a large multistate group clinical practice. The key to harnessing the potential of digital surveillance tools to promote patient-centered care during the COVID-19 pandemic was to use the registry data, reports, and dashboards as informatics tools to inform decision-making.
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Affiliation(s)
- Thulasee Jose
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - David O Warner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - John C O'Horo
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Steve G Peters
- Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | | | | | - Charles D Burger
- Division of Pulmonary, Allergy and Sleep Medicine, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL
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