Adaptation of an Evidence-Based Cardiovascular Health Intervention for Rural African Americans in the Southeast

Abstract

Background: African Americans (AA) living in the southeast United States have the highest prevalence of cardiovascular diseases (CVD) and rural minorities bear a significant burden of co-occurring CVD risk factors. Few evidencebased interventions (EBI) address social and physical environmental barriers in rural minority communities. We used intervention mapping together with community-based participatory research (CBPR) principles to adapt objectives of a multi-component CVD lifestyle EBI to fit the needs of a rural AA community. We sought to describe the process of using CPBR to adapt an EBI using intervention mapping to an AA rural setting and to identify and document the adaptations mapped onto the EBI and how they enhance the intervention to meet community needs. Methods: Focus groups, dyadic interviews, and organizational web-based surveys were used to assess content interest, retention strategies, and incorporation of auxiliary components to the EBI. Using CBPR principles, community and academic stakeholders met weekly to collaboratively integrate formative research findings into the intervention mapping process. We used a framework developed by Wilstey Stirman et al. to document changes. Results: Key changes were made to the content, context, and training and evaluation components of the existing EBI. A matrix including behavioral objectives from the original EBI and new objectives was developed. Categories of objectives included physical activity, nutrition, alcohol, and tobacco divided into three levels, namely, individual, interpersonal, and environmental. Conclusions: Intervention mapping integrated with principles of CBPR is an efficient and flexible process for adapting a comprehensive and culturally appropriate lifestyle EBI for a rural AA community context.

Community- and Patient-Partner Engagement in Women’s Cardiovascular Disease Research: A Rapid Review of the Evidence

“…In addition, 12 published manuscripts were identified from a specific citation search; these were included as a compendium to the original record identified in the search (ie, full-text papers to support conference abstracts). In total, 35 records 62 , 63 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 were included in the final review.

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses ( PRISMA) 2020 flow diagram.

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Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups

“…Successful PA interventions incorporated educational materials to increase at-home activity levels and develop weekly fitness goals [ 23 ••]. Evidence-based interventions such as PREMIER, a behavior change intervention focused on goal setting for diet, PA, and alcohol consumption, were utilized in rural AA communities [ 37 ]. Many successful frameworks involved setting fitness goals and PA plans with larger groups facilitated by coaches or leaders from the community to better serve and represent the population [ 23 ••].…”

A discussion among deans on advancing community engaged research

“…The underlying premise is that people who experience the disproportionate burden of disease, as well as the frontline health workforce and agencies who serve them, hold knowledge critical for both studying and addressing pressing public health concerns impacting them 2–5 . The benefits of community engagement in the design of highly effective public health interventions and the advancement of translational science have been established 6–8 . However, the adoption of CE and participatory approaches among health researchers remains limited.…”

“… 2 , 3 , 4 , 5 The benefits of community engagement in the design of highly effective public health interventions and the advancement of translational science have been established. 6 , 7 , 8 However, the adoption of CE and participatory approaches among health researchers remains limited.…”