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Perez LG, Flόrez KR, Seelam R, Williams MV, Derose KP. Effects of a Faith-Based Obesity Intervention on African American and Latino Adults' Children. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024:2752535X241235992. [PMID: 38406923 DOI: 10.1177/2752535x241235992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
BACKGROUND Faith-based interventions are promising for promoting healthy behaviors among adults, but their ripple effects on participants' children are unknown. This study is one of the first to assess the effects of a faith-based multilevel obesity intervention on adult participants' children. METHODS We analyzed quantitative data from a cluster randomized controlled trial with two African American and two Latino churches in South Los Angeles, California, which invited adult participants to enroll one child (5-17 years) in a sub-study. At baseline and 6-7 months follow-up, parents completed a child health survey, which included the family nutrition and physical activity screening tool, and child height and weight were measured (n = 50). RESULTS Results from linear regression models showed children of intervention participants, compared to control, had significantly better dietary patterns at follow-up. CONCLUSIONS Findings suggest the health benefits of a faith-based multilevel obesity intervention for adults can extend to children and may help address obesity disparities.
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Affiliation(s)
| | - Karen R Flόrez
- Center for Systems and Community Design, Graduate School of Public Health and Heath Policy, City University of New York, New York, NY, USA
| | | | | | - Kathryn P Derose
- RAND Corporation, Santa Monica, CA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amhers, Amherst, MA, USA
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Mwakisole AH, Lambert VJ, Nzali A, Aristide C, Laizer E, Cordeiro AA, Gregory L, Mwakisole N, Nicol CEW, Paul N, Kalluvya SE, Kihunrwa A, Downs DJ, Wamoyi J, Downs JA, Lee MH. Partnerships with religious leaders to promote family planning in rural Tanzania: an open-label, cluster randomised trial. Lancet Glob Health 2023; 11:e1943-e1954. [PMID: 37973342 DOI: 10.1016/s2214-109x(23)00453-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Family planning benefits maternal-child health, education, and economic wellbeing. Despite global efforts, an unsatisfied demand for family planning persists in sub-Saharan Africa. Based on previous successful partnerships, the aim of this study was to determine whether an educational intervention for religious leaders would increase community knowledge, demand for, and ultimately uptake of family planning. METHODS In this open-label, cluster randomised trial in Tanzania, 24 communities were randomised (1:1) to intervention or control arm. Communities, defined as the catchment area of a single public health facility, were eligible if they were at least 15 km from Mwanza City and had not previously participated in a health intervention for religious leaders. Random allocations were determined by coin toss and were not revealed to clinicians at health facilities in intervention and control communities, nor to the data entry team; however, due to the nature of the intervention, masking of religious leaders in the intervention communities was not possible. All Christian religious institutions were invited to send four leaders to an educational intervention that incorporated cultural, theological, and medical teaching about family planning. The primary outcome was contraceptive uptake at the community health facility during the year post intervention versus the year before the intervention. This trial was registered at clinicaltrials.gov, NCT03594305. FINDINGS 75 communities in three districts were assessed for eligibility. 19 communities were excluded and 56 were eligible for study inclusion and were placed in random order to be invited to participate. The first 24 communities that were invited agreed to participate and were randomly assigned to receive the educational intervention either during the trial or after trial completion. Between July 10, 2018 and Dec 11, 2021, we provided the intervention in 12 communities and compared contraceptive uptake with 12 control communities. All were followed up for 12 months. In intervention communities, contraceptive uptake increased by a factor of 1·47 (95% CI 1·41-1·53) in the post-intervention (prospective) versus pre-intervention (historical) year (geometric mean of contraceptive uptake, 466 in the prospective year vs 312 in the historical year), versus 1·24 (95% CI 1·20-1·29) in control communities (geometric mean, 521 in the prospective year vs 429 in the historical year). The rate of change in contraceptive uptake was greater in intervention communities (between-group ratio of geometric mean ratios over time, 1·19 [95% CI 1·12-1·25]; p<0·0001). The COVID-19 pandemic was associated with decreased contraceptive uptake (geometric mean, 365 during the pandemic in communities that had the majority of their prospective 12-month data collection periods occur after March 16, 2020, vs 494 before the pandemic; geometric mean ratio, 0·72 [95% CI 0·57-0·90]; p=0·0040). INTERPRETATION This intervention offers a scalable model, leveraging influence of trusted religious leaders to increase knowledge and uptake of family planning. New strategies such as this could help to overcome setbacks that occurred during the COVID-19 pandemic. FUNDING John Templeton Foundation and Weill Cornell Medicine Dean's Diversity and Healthcare Disparity Award. TRANSLATION For the Kiswahili translation of the abstract see Supplementary Materials section.
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Affiliation(s)
| | | | - Aneth Nzali
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
| | | | | | | | | | | | - Cecilia E W Nicol
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Ndalloh Paul
- Department of Emergency Medicine, Bugando Medical Centre, Mwanza, Tanzania
| | | | - Albert Kihunrwa
- Department of Obstetrics and Gynaecology, Bugando Medical Centre, Mwanza, Tanzania
| | - David J Downs
- Faculty of Theology and Religion, University of Oxford, Oxford, UK
| | - Joyce Wamoyi
- National Institute for Medical Research, Mwanza, Tanzania
| | - Jennifer A Downs
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA; Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania.
| | - Myung Hee Lee
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
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Sher C, Wu C. Race, immigrant status, and inequality in physical activity: An intersectional and life course approach. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2023; 60:763-800. [PMID: 37615391 DOI: 10.1111/cars.12451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Physical activity improves health and well-being, but not everyone can be equally active. Previous research has suggested that racial minorities are less active than their white counterparts and immigrants are less active than their native-born counterparts. In this article, we adopt an intersectional and life course approach to consider how race and immigrant status may intersect to affect physical activity across the life span. This new approach also allows us to test the long-standing habitual versus structural debate in physical activity. Analysing data from two recent cycles of the Canadian Community Health Survey (CCHS, 2015-2016 & 2017-2018), we find that physical activity is only lower among immigrants who are also racial minorities and that the gap is most significant during adulthood, but rather insignificant during adolescence and late life. The findings that inequality in physical activity is more apparent among the most disadvantaged racialised immigrants and among working-age adults when structural influences are greater suggest that inequality in physical activity is rooted in structural inequalities, rather than habitual differences. Finally, we demonstrate that the widely observed 'healthy (racialised) immigrant effect' can be underestimated if inequality in physical activity is not considered.
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Affiliation(s)
- Chloe Sher
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Cary Wu
- Department of Sociology, York University, Toronto, Ontario, Canada
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Quintiliani LM, Dedier J, Amezquita M, Sierra-Ruiz M, Romero D, Murillo J, Mahar S, Goodman M, Kane JB, Cummings D, Woolley TG, Spinola I, Crouter SE. Community Walks: a cluster randomized controlled trial of a multilevel physical activity intervention for low income public housing residents. BMC Public Health 2023; 23:1676. [PMID: 37653386 PMCID: PMC10470135 DOI: 10.1186/s12889-023-16574-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Physical activity behavioral interventions to change individual-level drivers of activity, like motivation, attitudes, and self-efficacy, are often not sustained beyond the intervention period. Interventions at both environmental and individual levels might facilitate durable change. This community-based study seeks to test a multilevel, multicomponent intervention to increase moderate intensity physical activity among people with low incomes living in U.S. public housing developments, over a 2 year period. METHODS The study design is a prospective, cluster randomized controlled trial, with housing developments (n=12) as the units of randomization. In a four-group, factorial trial, we will compare an environmental intervention (E) alone (3 developments), an individual intervention (I) alone (3 developments), an environmental plus individual (E+I) intervention (3 developments), against an assessment only control group (3 developments). The environmental only intervention consists of community health workers leading walking groups and indoor activities, a walking advocacy program for residents, and provision of walking maps/signage. The individual only intervention consists of a 12-week automated telephone program to increase physical activity motivation and self-efficacy. All residents are invited to participate in the intervention activities being delivered at their development. The primary outcome is change in moderate intensity physical activity measured via an accelerometer-based device among an evaluation cohort (n=50 individuals at each of the 12 developments) from baseline to 24-month follow up. Mediation (e.g., neighborhood walkability, motivation) and moderation (e.g., neighborhood stress) of our interventions will be assessed. Lastly, we will interview key informants to assess factors from the Consolidated Framework for Implementation Research domains to inform future implementation. DISCUSSION We hypothesize participants living in developments in any of the three intervention groups (E only, I only, and E+I combined) will increase minutes of moderate intensity physical activity more than participants in control group developments. We expect delivery of an intervention package targeting environmental and social factors to become active, combined with the individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. If effective, this trial has the potential for implementation through other federal and state housing authorities. TRIAL REGISTRATION Clinical Trails.gov PRS Protocol Registration and Results System, NCT05147298 . Registered 28 November 2021.
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Affiliation(s)
- Lisa M Quintiliani
- Boston University, Chobanian and Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.
| | - Julien Dedier
- Boston University, Chobanian and Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Marislena Amezquita
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Melibea Sierra-Ruiz
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Dariela Romero
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Jennifer Murillo
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Sarah Mahar
- School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA
| | - Melody Goodman
- Department of Biostatistics, School of Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - John B Kane
- Grants and Strategic Partnerships, Boston Housing Authority, 52 Chauncy St, Boston, MA, 02111, USA
| | - Doreen Cummings
- Trinity Management Company, LLC, 75 Federal St. Floor 4, Boston, MA, 02110, USA
| | | | - Iolando Spinola
- WalkMassachusetts, 50 Milk St. 16th Floor, Boston, MA, 021109, USA
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee Knoxville, 1914 Andy Holt Avenue, Knoxville, TN, 37996, USA
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Thomas VE, Metlock FE, Hines AL, Commodore-Mensah Y, Brewer LC. Community-Based Interventions to Address Disparities in Cardiometabolic Diseases Among Minoritized Racial and Ethnic Groups. Curr Atheroscler Rep 2023; 25:467-477. [PMID: 37428390 DOI: 10.1007/s11883-023-01119-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW Cardiometabolic diseases (CMDs) are leading causes of death and disproportionally impact historically marginalized racial/ethnic groups in the United States. The American Heart Association developed the Life's Essential 8 (LE8) to promote optimal cardiovascular health (CVH) through eight health behaviors and health factors. The purpose of this review is to summarize contemporary community-engaged research (CER) studies incorporating the LE8 framework among racial/ethnic groups. REVIEW OF FINDINGS Limited studies focused on the interface of CER and LE8. Based on synthesis of articles in this review, the application of CER to individual/collective LE8 metrics may improve CVH and reduce CMDs at the population level. Effective strategies include integration of technology, group activities, cultural/faith-based practices, social support, and structural/environmental changes. CER studies addressing LE8 factors in racial/ethnic groups play an essential role in improving CVH. Future studies should focus on broader scalability and health policy interventions to advance health equity.
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Affiliation(s)
- Victoria E Thomas
- Division of Cardiovascular Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Faith E Metlock
- John Hopkins University School of Nursing, Baltimore, MD, USA
| | - Anika L Hines
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Yvonne Commodore-Mensah
- John Hopkins University School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - LaPrincess C Brewer
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
- Mayo Clinic Center for Health Equity and Community Engagement Research, Rochester, MN, USA.
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Velarde G, Bravo‐Jaimes K, Brandt EJ, Wang D, Douglass P, Castellanos LR, Rodriguez F, Palaniappan L, Ibebuogu U, Bond R, Ferdinand K, Lundberg G, Thamman R, Vijayaraghavan K, Watson K. Locking the Revolving Door: Racial Disparities in Cardiovascular Disease. J Am Heart Assoc 2023; 12:e025271. [PMID: 36942617 PMCID: PMC10227271 DOI: 10.1161/jaha.122.025271] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Racial disparities in cardiovascular disease are unjust, systematic, and preventable. Social determinants are a primary cause of health disparities, and these include factors such as structural and overt racism. Despite a number of efforts implemented over the past several decades, disparities in cardiovascular disease care and outcomes persist, pervading more the outpatient rather than the inpatient setting, thus putting racial and ethnic minority groups at risk for hospital readmissions. In this article, we discuss differences in care and outcomes of racial and ethnic minority groups in both of these settings through a review of registries. Furthermore, we explore potential factors that connote a revolving door phenomenon for those whose adverse outpatient environment puts them at risk for hospital readmissions. Additionally, we review promising strategies, as well as actionable items at the policy, clinical, and educational levels aimed at locking this revolving door.
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Affiliation(s)
- Gladys Velarde
- Department of CardiologyUniversity of FloridaJacksonvilleFL
| | | | | | - Daniel Wang
- Division of CardiologyUniversity of CaliforniaLos AngelesCA
| | - Paul Douglass
- Division of CardiologyWellstar Atlanta Medical CenterAtlantaGA
| | | | - Fatima Rodriguez
- Division of Cardiology and the Cardiovascular InstituteStanford University School of MedicinePalo AltoCA
| | | | - Uzoma Ibebuogu
- Division of CardiologyUniversity of Tennessee Health Science CenterMemphisTN
| | - Rachel Bond
- Division of CardiologyDignity HealthGilbertAZ
- Division Cardiology, Department of Internal MedicineCreighton University School of MedicineOmahaNE
| | - Keith Ferdinand
- Division of CardiologyTulane School of MedicineNew OrleansLA
| | | | - Ritu Thamman
- Division of CardiologyUniversity of PittsburghPittsburghPA
| | | | - Karol Watson
- Division of CardiologyUniversity of CaliforniaLos AngelesCA
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Whitley MD, Perez LG, Castro G, Larson A, Derose KP. Modifying Text Messages from a Faith-Based Physical Activity Intervention with Latino Adults in Response to the COVID-19 Pandemic. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023:2752535X221150009. [PMID: 36651265 PMCID: PMC9852972 DOI: 10.1177/2752535x221150009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Text messages are useful for health promotion and can be modified during public health emergencies. PURPOSE Describe how we developed and implemented a physical activity (PA) text messaging component within a faith-based intervention, modified the text message content in response to the COVID-19 pandemic and evaluated participants' perceptions of the modified text messages. RESEARCH DESIGN AND STUDY SAMPLE PA promotion text messages were delivered to predominately Spanish-speaking, churchgoing Latino adults (n = 284) in Los Angeles, California. In 2020, we modified the messages to disseminate COVID-19-related information and support and share virtual PA resources. DATA COLLECTION AND ANALYSIS We analyzed quantitative and qualitative survey data to gauge participants' experiences with the text messages. RESULTS COVID-19 related text messages were a feasible, acceptable addition to a PA intervention for a sample of Latinos. CONCLUSIONS Throughout the pandemic, the messages enabled continued communication and support for PA and protection from COVID-19 in a population at high-risk of health inequities.
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Affiliation(s)
- Margaret D Whitley
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
| | - Lilian G Perez
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
| | - Gabriela Castro
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
| | - Anne Larson
- California State University, Los Angeles, Los Angeles, CA, USA
| | - Kathryn P Derose
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
- Department of Health Promotion & Policy, University of Massachusetts Amherst, Amherst, MA, USA
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Oh AY, Rising CJ, Gaysynsky A, Tsakraklides S, Huang GC, Chou WYS, Blake KD, Vanderpool RC. Advancing multi-level health communication research: A Delphi study on barriers and opportunities. Transl Behav Med 2022; 12:1133-1145. [PMID: 36378100 PMCID: PMC9802573 DOI: 10.1093/tbm/ibac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adopting a multi-level perspective that considers the many interrelated contexts influencing health could make health communication interventions more effective and equitable. However, despite increasing interest in the use of multi-level approaches, multi-level health communication (MLHC) interventions are infrequently utilized. We therefore sought to conduct a modified Delphi study to better understand how researchers conceptualize MLHC interventions and identify opportunities for advancing MLHC work. Communication and health behavior experts were invited to complete two rounds of surveys about the characteristics, benefits, pitfalls, best practices, barriers, and facilitators of MLHC interventions; the role of technology in facilitating MLHC interventions; and ways to advance MLHC intervention research (46 experts completed the first survey, 44 completed both surveys). Survey data were analyzed using a mixed-methods approach. Panelists reached consensus on two components of the proposed definition of MLHC interventions and also put forward a set of best practices for these interventions. Panelists felt that most health intervention research could benefit from a multi-level approach, and generally agreed that MLHC approaches offered certain advantages over single-level approaches. However, they also expressed concern related to the time, cost, and complexity of MLHC interventions. Although panelists felt that technology could potentially support MLHC interventions, they also recognized the potential for technology to exacerbate disparities. Finally, panelists prioritized a set of methodological advances and practical supports that would be needed to facilitate future MLHC intervention research. The results of this study point to several future directions for the field, including advancing how interactions between levels are assessed, increasing the empirical evidence base demonstrating the advantages of MLHC interventions, and identifying best practices for the use of technology. The findings also suggest that researchers may need additional support to overcome the perceived practical challenges of conducting MLHC interventions.
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Affiliation(s)
- April Y Oh
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
- ICF Next, ICF, Rockville, MD, USA
| | | | - Grace C Huang
- Public Health and Epidemiology, Westat, Rockville, MD, USA
| | - Wen-Ying Sylvia Chou
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kelly D Blake
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Robin C Vanderpool
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Derose KP, Cohen DA, Han B, Arredondo EM, Perez LG, Larson A, Loy S, Mata MA, Castro G, De Guttry R, Rodríguez C, Seelam R, Whitley MD, Perez S. Linking churches and parks to promote physical activity among Latinos: Rationale and design of the Parishes & Parks cluster randomized trial. Contemp Clin Trials 2022; 123:106954. [PMID: 36206951 PMCID: PMC9783594 DOI: 10.1016/j.cct.2022.106954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Regular physical activity (PA) contributes to positive health outcomes, but a minority of US adults meet minimum guidelines for moderate-to-vigorous PA (MVPA) and muscle-strengthening, and Latinos are less likely than whites to meet these guidelines. Public parks can be leveraged for community PA but tend to be underutilized, while churches have reach within Latino communities and can influence parishioners' health. METHODS We are conducting a cluster randomized controlled trial to examine the impact of a multilevel, faith-based intervention linking Catholic parishes (n = 14) to their local parks on adult Latino parishioners' (n = 1204) MVPA and health-related outcomes. Our approach targets multiple levels (individual, group, church, and neighborhood-park) to promote health-enhancing PA through park-based exercise classes led by kinesiology students, peer leader-led walking groups, park-based church events, church-based PA support activities, and environmental advocacy. Data are collected at churches by trained bilingual/bicultural research assistants using accelerometry, surveys, and biometric procedures. We will implement a set of hierarchical repeated-measure linear models to examine effects on the primary outcome (MVPA) and secondary outcomes (self-reported PA, heart rate/fitness, waist circumference, waist-to-hip ratio, body fat, mental health, and perceived social support for PA). We will also conduct a process evaluation. CONCLUSION To our knowledge, this will be the first study examining efficacy of an integrated church and park-based intervention on Latino adults' PA and represents a scalable model of PA programming for low-income communities. The intervention makes use of innovative partnerships within and across sectors - faith-based, local parks/city government, and local universities - further facilitating sustainability. CLINICALTRIALS govID: NCT03858868.
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Affiliation(s)
- Kathryn P Derose
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA; University of Massachusetts Amherst, Department of Health Promotion & Policy, 705 N. Pleasant St, Amherst, MA 01003, USA.
| | - Deborah A Cohen
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA; Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S Los Robles, Pasadena, CA 91101, USA.
| | - Bing Han
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA; Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S Los Robles, Pasadena, CA 91101, USA.
| | - Elva M Arredondo
- San Diego State University, Psychology Department and Institute for Behavioral and Community Health Studies, 9245 Sky Park Ct, #221, San Diego, CA 92123, USA.
| | - Lilian G Perez
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Anne Larson
- California State University, Los Angeles, School of Kinesiology, 5151 State University Drive, Los Angeles, CA 90032, USA.
| | - Steven Loy
- California State University, Northridge, Department of Kinesiology, 18111 Nordhoff Street, Northridge, CA 91330, USA.
| | - Michael A Mata
- Los Angeles First Church of the Nazarene, 3401 W. Third St., Los Angeles, CA 90020, USA
| | - Gabriela Castro
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Rebecca De Guttry
- Pardee RAND Graduate School, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Claudia Rodríguez
- Pardee RAND Graduate School, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Rachana Seelam
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | | | - Sergio Perez
- Archdiocese of Los Angeles, San Gabriel Pastoral Region, 16009 E Cypress, Irwindale, CA 91706, 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 2022:10.1007/s10943-022-01638-x. [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] [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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Julian McFarlane S, Occa A, Peng W, Awonuga O, Morgan SE. Community-Based Participatory Research (CBPR) to Enhance Participation of Racial/Ethnic Minorities in Clinical Trials: A 10-Year Systematic Review. HEALTH COMMUNICATION 2022; 37:1075-1092. [PMID: 34420460 DOI: 10.1080/10410236.2021.1943978] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There has not been a significant improvement in the rate of clinical trial accrual in more than 20 years. Worse, the challenge of inadequate representation among racial and ethnic minorities also persists, deepening disparities in health. Community-Based Participatory Research (CBPR) is a participatory communication method that centers on effective dialogue between researchers and community stakeholders with the goal of creating an equitable partnership for health and social change. The objective of the current study was to provide an update since a systematic review in 2012, on the current status of the empirical research, with a particular focus on the elements of CBPR methods used to improve the rate of accrual of members of racial and ethnic minority communities for clinical trials. Our systematic review found a large increase in the number of CBPR related studies and studies related to racial and ethnic representation in research. More than 85% of studies employing CBPR methods saw statistically positive outcomes. Specifically, the elements of CBPR that are associated with these positive outcomes include community partner participation in (1) a study advisory committee, (2) data collection, (3) the development of interventions, and (4) participant recruitment. However, the results of our study indicate that researchers need to be more transparent about the extent of community participation as well as more thoroughly and accurately describe the nature of the partnership with members of minority communities in order to build upon the scientific literature on community-engaged methods.
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Affiliation(s)
| | - Aurora Occa
- Department of Communication, University of Kentucky
| | - Wei Peng
- Murrow College of Communication, Washington State University
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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.
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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
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Payán DD, Lewis LB, Illum J, Hawkins B, Sloane DC. United for health to improve urban food environments across five underserved communities: a cross-sector coalition approach. BMC Public Health 2022; 22:888. [PMID: 35509034 PMCID: PMC9066811 DOI: 10.1186/s12889-022-13245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 04/18/2022] [Indexed: 11/28/2022] Open
Abstract
Background Cross-sector coalitions can be a powerful vehicle to promote adoption and implementation of evidence-based programs and policies across diverse racial/ethnic communities with a high chronic disease burden. Few studies have examined coalition composition, function, or capacity to promote learning among members. Methods We used a mixed methods approach to examine the United for Health coalition’s implementation of multiple food environment interventions across five low-income communities of color in Los Angeles, California (USA). At the coalition-level, key measures included the collaborative environment, membership characteristics, process and structure, communication, resources, strengths, challenges/barriers, and community impact. At the organizational- and individual-levels, we collected data on participation, leadership development, intraorganizational change, perceived benefits, and learning outcomes. Findings Overall, the United for Health coalition produced five community gardens, three pop-up produce markets, and one farmers’ market; members also expanded Electronic Benefits Transfer (EBT) access at three existing farmers’ markets. Findings indicate early coalition strengths included having a mutual purpose, which was maintained throughout the study period. Coalition participation and engagement was consistently high, while coalition and inter-organizational communication improved over time. Strengths were membership diversity and the availability of learning opportunities. Benefits included leadership development and strategic alignment across organizations. Members demonstrated an increased awareness of the importance of culturally adapted interventions and knowledge of community health planning topics. Key implementation challenges were a lack of resources and social context barriers. Conclusions Examining coalition function and maturation in a real-world context reveals important lessons for scholars and practitioners committed to addressing nutrition-related health disparities in marginalized and historically underserved communities. Future work should investigate the sustainability of externally funded cross-sector coalitions after funding ceases. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13245-2.
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Affiliation(s)
- Denise D Payán
- Department of Health, Society, and Behavior, University of California Irvine, Irvine, CA, 92697, USA.
| | - LaVonna B Lewis
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| | - Jacqueline Illum
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| | - Breanna Hawkins
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| | - David C Sloane
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
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Burchenal C, Tucker S, Soroka O, Antoine F, Ramos R, Anderson H, Tettey NS, Phillips E. Developing Faith-Based Health Promotion Programs that Target Cardiovascular Disease and Cancer Risk Factors. JOURNAL OF RELIGION AND HEALTH 2022; 61:1318-1332. [PMID: 34851497 DOI: 10.1007/s10943-021-01469-2] [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: 11/15/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study was to evaluate the impact of a faith-based health promotion program on the ideal health behaviors shared between cardiovascular disease (CVD) and cancer. The primary purpose was to measure the individual-level change in three categories of shared risk behaviors between CVD and cancer (body weight, physical activity, and nutrition) among program participants. Additionally, we evaluated the association of churches' perceived environmental support on these ideal health behaviors. Baseline and 10-week surveys were conducted to assess BMI, ideal health behaviors (diet and physical activity), and a Healthy Lifestyle Score (HLS) was created to measure adherence to health behaviors. A Supportive Church Environment Score (SCES) was designed to address the second objective. Psychosocial factors (stress and coping skills) and demographics were also measured. The percentage of participants meeting diet and exercise recommendations significantly increased with the completion of the program. Whole-grain intake increased by 64% (p = 0.085), vegetable intake increased by 58% (p = < 0.001), fruit intake increased by 39% (p = < 0.001), physical activity increased by 14% (p = < 0.001), and red meat consumption decreased by 19% (p = < 0.001). The median HLS increased from 7 to 8 (p = < 0.001). At baseline the association between ideal health behaviors and the SCES was significant for fruit intake (r = 0.22, p-value = 0.003) and red meat consumption (r = 0.17, p-value = 0.02). The aggregate behaviors as represented by the HLS were associated with the SCES (r = 0.19, p-value = 0.03). The significant increase in the HLS indicates an average improvement in the degree to which participants were meeting recommendations after completing the program. Therefore, adherence to these ideal health behaviors increased over the 10-week program.
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Affiliation(s)
- Clare Burchenal
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Shanna Tucker
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Orysya Soroka
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Francesse Antoine
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Rosio Ramos
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Holly Anderson
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Naa-Solo Tettey
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Erica Phillips
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA.
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Maxwell AE, Vargas C, Santifer R, Chang LC, Crespi CM, Lucas-Wright A. Facilitators and Challenges to Health Promotion in Black and Latino Churches. J Racial Ethn Health Disparities 2022; 9:59-67. [PMID: 33230738 PMCID: PMC8141063 DOI: 10.1007/s40615-020-00929-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Churches are important assets for the African American and Latino communities. They can play a critical role in health promotion, especially in areas that are under-resourced and in which residents have limited access to health care. A better understanding of health promotion in churches is needed to support and maintain church collaborations and health initiatives that are integrated, data-driven, and culturally appropriate. The purpose of this study is to identify churches' facilitators and challenges to health promotion and to contrast and compare Black and Latino churches of different sizes (< 200 members versus > 200 members). METHODS We interviewed leaders of 100 Black and 42 Latino churches in South Los Angeles to assess their history of wellness activities, resources, facilitators, and challenges to conduct health promotion activities. RESULTS Eighty-three percent of African American and 86% of Latino church leaders reported at least one health activity in the last 12 months. Black and Latino churches of different sizes have similar interests in implementing specific health promotion strategies and face similar challenges. However, we found significant differences in the composition of their congregations, number of paid staff, and the proportions of churches that have a health or wellness ministry and that implement specific wellness strategies. Fifty-seven percent of African American and 43% of Latino church leaders stated that they needed both financial support and professional expertise for health promotion. DISCUSSION Our findings highlight the importance of conducting a readiness assessment for identifying intervention content and strategies that fit the intervention context of a church.
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Affiliation(s)
- Annette E Maxwell
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Claudia Vargas
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Rhonda Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - L Cindy Chang
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Catherine M Crespi
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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16
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Study protocol for comparing Screening, Brief Intervention, and Referral to Treatment (SBIRT) to referral as usual for depression in African American churches. Trials 2022; 23:93. [PMID: 35101100 PMCID: PMC8801931 DOI: 10.1186/s13063-021-05767-8] [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: 04/01/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Depression is a leading cause of disability worldwide. African American adults, compared to White adults, are half as likely to be screened for depression in primary care settings. Disparities in depression screening contribute to poor clinical outcomes, as African Americans with depression are more disabled and sicker longer compared to Whites. African American churches are trusted settings that provide access to supports for depression. Indeed, in the first study of its kind, the investigators found that 20% of adults in African American churches screened positive for depression using the Patient Health Questionnaire-9 (PHQ-9). However, no subjects with a positive screen (PHQ-9 ≥ 10) accepted a treatment referral when offered by research personnel. Community Health Workers, who are trusted paraprofessionals from the target community, may bridge the gap between depression screening and treatment. The investigators have trained and certified 112 Community Health Workers from 45 African American churches in New York City to deliver an evidence-based intervention called Screening, Brief Intervention, and Referral to Treatment (SBIRT). Thus, the aim of the current study is to test the impact of Community Health Worker-delivered depression screening in Black churches on engagement with clinical services. Methods Using a hybrid type 1 effectiveness-implementation design, we propose a 2-arm, mixed-methods cluster randomized controlled trial. Church study sites will be randomized to either SBIRT (intervention arm) or referral as usual (usual care arm). This trial will be conducted with 600 church members across 30 churches (300 intervention; 300 usual care). Our primary outcome is treatment engagement, defined as attending a depression-related clinical visit. Secondary outcomes will be changes in Mental Health-Related Quality of Life and depressive symptoms at 3 and 6 months post-screening. Lastly, we will conduct a concurrent, mixed-methods (qualitative-quantitative) process evaluation to assess contextual facilitators and barriers of screening and referral. Discussion This is the first randomized trial of a church-placed, community health worker-delivered intervention for depression in African American populations. This study may provide a novel and effective approach to increasing depression identification and treatment linkage in economically disadvantaged populations with high depression rates. Trial registration ClinicalTrials.govNCT04524767. Registered on 21 August 2020.
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Fosu M, Teye-Kwadjo E, Salifu Yendork J. Patient-Reported Experiences of Medication Adherence at a Community-Based HIV Clinic, Ghana. J Patient Exp 2022; 9:23743735221107263. [PMID: 35719416 PMCID: PMC9203957 DOI: 10.1177/23743735221107263] [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] [Indexed: 11/18/2022] Open
Abstract
There is little information on patients’ medication adherence experiences at community-based clinics in Ghana. This study investigated adherence to antiretroviral medication among people living with HIV (PLHIV) attending a community-based HIV clinic. PLHIV (N = 349) completed a questionnaire battery on medication adherence, doctor–patient communication, HIV stigma, patient general self-efficacy, perceived social support, and on patient spirituality. Linear Regression was used to analyze the data. Results showed that doctor–patient communication (β = .38, 95% CI [0.09, 0.18], P <.001) and social support from significant others (β = .46, 95% CI [0.18, 0.67], P <.001) were positively associated with medication adherence in this sample. In contrast, HIV stigma (β = –.16, 95% CI [–0.58, −0.09], P <.01), patient spirituality (β = –.22, 95% CI [–0.44, −0.00], P <.05), and patient general self-efficacy (β = –.14, 95% CI [–0.17, −0.02], P <.01) were negatively associated with medication adherence. There is a need for educational interventions targeted at enhancing doctor–patient communication and social support while reducing stigma among PLHIV in Ghana.
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Affiliation(s)
- Morrison Fosu
- Department of Psychology, University of Ghana, Legon, Accra, Ghana
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18
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Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups. CURR EPIDEMIOL REP 2022; 9:212-221. [PMID: 36003088 PMCID: PMC9392701 DOI: 10.1007/s40471-022-00298-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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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Garcia J, Vargas N, de la Torre C, Magana Alvarez M, Clark JL. Engaging Latino Families About COVID-19 Vaccines: A Qualitative Study Conducted in Oregon, USA. HEALTH EDUCATION & BEHAVIOR 2021; 48:747-757. [PMID: 34596462 PMCID: PMC8581716 DOI: 10.1177/10901981211045937] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Latinos are disproportionately vulnerable to severe COVID-19 due to workplace exposure, multigenerational households, and existing health disparities. Rolling out COVID-19 vaccines among vulnerable Latinos is critical to address disparities. This study explores vaccine perceptions of Latino families to inform culturally centered strategies for vaccine dissemination. Method Semistructured telephone interviews with Latino families (22 mothers and 24 youth, 13–18 years old) explored COVID-19 vaccine perceptions including (1) sources of information, (2) trust of vaccine effectiveness and willingness to get vaccinated, and (3) access to the vaccine distribution. We identified thematic patterns using immersion–crystallization. Results We found that (1) 41% expressed optimism and willingness to receive the vaccine coupled with concerns about side effects; (2) 45% expressed hesitancy or would refuse vaccination based on mistrust, myths, fear of being used as “guinea pigs,” and the perceived role of politics in vaccine development; (3) families “digested” information gathered from social media, the news, and radio through intergenerational communication; and (4) participants called for community-led advocacy and “leading by example” to dispel fear and misinformation. Optimistic participants saw the vaccine as a way to protect their families, allowing youth to return to schools and providing safer conditions for frontline essential workers. Conclusions Culturally centered vaccine promotion campaigns may consider the Latino family unit as their target audience by providing information that can be discussed among parents and youth, engaging a range of health providers and advocates that includes traditional practitioners and community health workers, and disseminating information at key venues, such as schools, churches, and supermarkets.
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Payán DD, Flórez KR, Williams MV, Oden CW, Mata MA, Branch CA, Whitley MD, Derose KP. Sermons to Address Obesity in Partnership With African American and Latino Churches. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:811-815. [PMID: 34120832 PMCID: PMC8440423 DOI: 10.1016/j.jneb.2021.04.469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Denise D Payán
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, Merced, CA.
| | - Karen R Flórez
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | | | - Clyde W Oden
- Bethel African Methodist Episcopal Church, Oxnard, CA
| | | | | | | | - Kathryn P Derose
- RAND Corporation, Santa Monica, CA; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
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21
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Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses. NPJ Digit Med 2021; 4:114. [PMID: 34294852 PMCID: PMC8298448 DOI: 10.1038/s41746-021-00486-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/21/2021] [Indexed: 12/17/2022] Open
Abstract
Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted a systematic search to identify studies with systolic blood pressure (SBP) outcomes located in urban settings in high-income countries that included a digital health disparity population, defined as mean age ≥65 years; lower educational attainment (≥60% ≤high school education); and/or racial/ethnic minority (<50% non-Hispanic White for US studies). Interventions were categorized using an established self-management taxonomy. We conducted a narrative synthesis; among randomized clinical trials (RCTs) with a six-month SBP outcome, we conducted random-effects meta-analyses. Twenty-nine articles (representing 25 studies) were included, of which 15 were RCTs. Fifteen studies used text messaging; twelve used mobile applications. Studies were included based on race/ethnicity (14), education (10), and/or age (6). Common intervention components were: lifestyle advice (20); provision of self-monitoring equipment (17); and training on digital device use (15). In the meta-analyses of seven RCTs, SBP reduction at 6-months in the intervention group (mean SBP difference = -4.10, 95% CI: [-6.38, -1.83]) was significant, but there was no significant difference in SBP change between the intervention and control groups (p = 0.48). The use of mHealth tools has shown promise for chronic disease management but few studies have included older, limited educational attainment, or minority populations. Additional robust studies with these populations are needed to determine what interventions work best for diverse hypertensive patients.
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Adams RD, Tyson CA. "There is a Balm in Gilead": Black Social Workers' Spiritual Counterstory on the COVID-19 Crisis. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:523-532. [PMID: 32970547 DOI: 10.1080/19371918.2020.1806169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The authors assert that art-based inquiry can serve as a powerful medium for understanding the connection between faith and resilience as perceived and understood by older African-Americans adults disproportionately affected by the COVID-19 pandemic. Utilizing the CRT method of counterstorytelling as our conduit to elucidate our culturally situated responses to the COVID-19 pandemic. We seek to explore the connections between faith and resilience in social work practice during this public health crisis. Drawing from our shared experiences as two Black social workers we discuss the role spirituality plays in mitigating loneliness and stress among socially isolated older African-American adults (i.e., social distancing). Finally, with physical contact limited (i.e., social distancing) because of COVID-19, implications and recommendations for using spiritual-based practices with older African-American adults and families are discussed.
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Affiliation(s)
- Raymond D Adams
- College of Liberal and Performing Arts, Southern Arkansas University , Magnolia, Arkansas, USA
- Department of Behavioral and Social Sciences, Southern Arkansas University , Magnolia, Arkansas, USA
| | - Cynthia A Tyson
- College of Education and Human Ecology, Ohio State University , Columbus, Ohio, USA
- Department of Teaching and Learning, Ohio State University , Columbus, Ohio, USA
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Payán DD, Derose KP, Flórez KR, Branch CA, Williams MV. The Food Environment in 3 Neighborhoods in South Los Angeles, California: Access, Availability, Quality, and Marketing Practices. Prev Chronic Dis 2020; 17:E61. [PMID: 32678063 PMCID: PMC7380293 DOI: 10.5888/pcd17.200028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Denise D Payán
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, 5200 N Lake Rd, Merced, CA 95343.
| | | | - Karen R Flórez
- City University of New York, Graduate School of Public Health and Health Policy, New York, New York
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Ralston PA, Wickrama KKAS, Coccia CC, Lemacks JL, Young-Clark IM, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Dietary Behaviors in Older African Americans. Am J Prev Med 2020; 58:361-369. [PMID: 31866211 PMCID: PMC7039745 DOI: 10.1016/j.amepre.2019.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Church-based interventions have been shown to improve the dietary health of underserved populations, yet few studies have examined sustainability of health behavior change over time. This paper examines dietary outcomes over a 24-month period (baseline and 6, 18, and 24 months) for fruit and vegetable and fat consumption behaviors of African-American participants in the Health for Hearts United church-based intervention in North Florida. STUDY DESIGN This quasi-experimental, longitudinal trial was conducted from 2009 to 2012. Data were analyzed in 2018. SETTING/PARTICIPANTS Six churches in a 2-county area (3 treatment, 3 comparison) were selected for the study using community-based participatory research approaches. Participants were African-American adults (aged ≥45 years; n=211 at baseline) randomly selected from the churches, stratified by age and sex. INTERVENTION Health for Hearts United intervention was developed by the 3 treatment churches. The 18-month intervention was implemented in 3 6-month phases, framed around 3 conceptual components, which included 4 types of programs and 4 key messages. MAIN OUTCOME MEASURES Fruit and vegetable consumption was assessed using a single item (fruit and vegetable intake) and the National Cancer Institute Fruit and Vegetable Screener. Fat consumption was determined using a single item (fat intake) and the National Cancer Institute Fat Screener. Background characteristics included age, sex, educational level, and marital status. RESULTS Significant time effects only were found for daily fruit and vegetable intake (p<0.001), fat intake (p<0.001), and the Fat Screener (p<0.001) with dietary improvements in both treatment and comparison groups across the intervention phases. Fruit and Vegetable Screener results showed that time (p<0.001) and the interaction between time and treatment (p<0.01) were significant, with increases in fruit and vegetable consumption over time for both the treatment and comparison groups and with the increase differing between groups. Post hoc analysis revealed that the treatment group had greater increases in fruit and vegetable consumption than the comparison group between Phases 1 and 3 (p=0.03). CONCLUSIONS Dietary behaviors of mid-life and older African Americans can be improved and sustained over 24 months using a church-based heart health intervention, with similar improvements noted for both comparison and treatment participants. TRIAL REGISTRATION This study is registered at www.clinicaltrials.govNCT03339050.
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Affiliation(s)
- Penny A Ralston
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida.
| | | | - Catherine C Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida
| | - Jennifer L Lemacks
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi
| | - Iris M Young-Clark
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida
| | - Jasminka Z Ilich
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida; Institute for Successful Longevity, Florida State University, Tallahassee, Florida
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Whitley MD, Payán DD, Flórez KR, Williams MV, Wong EC, Branch CA, Derose KP. Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos. Health Informatics J 2019; 26:880-896. [PMID: 31203706 DOI: 10.1177/1460458219853408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Church-based programs can act on multiple levels to improve dietary and physical activity behaviors among African Americans and Latinos. However, the effectiveness of these interventions may be limited due to challenges in reaching all congregants or influencing behavior outside of the church setting. To increase intervention impact, we sent mobile messages (text and email) in English or Spanish to congregants (n = 131) from predominantly African American or Latino churches participating in a multi-level, church-based program. To assess feasibility and acceptability, we collected feedback throughout the 4-month messaging intervention and conducted a process evaluation using the messaging platform. We found that the intervention was feasible to implement and acceptable to a racially ethnically diverse study sample with high obesity and overweight rates. While the process evaluation had some limitations (e.g. low response rate), we conclude that mobile messaging is a promising, feasible addition to church-based programs aiming to improve dietary and physical activity behaviors.
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