Exploring the intervention effect moderators of a cardiovascular health promotion study among rural African‐Americans

Abbott, Laurie; Schluck, Glenna; Graven, Lucinda J.; Martorella, Géraldine

doi:10.1111/phn.12377

Cited by 7 publications

(19 citation statements)

References 36 publications

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“…MIM DASH did not improve diet, mindfulness affect, or perceived stress. Because diagnosis of hypertension was an inclusion criteria, the participants' knowledge of their heart disease may have exerted a moderating effect on their self‐efficacy to make dietary changes, as is reported in a study of African Americans who participated in a cardiovascular health promotion study 21 . Participants in our study reported low stress and above average mindfulness affect at baseline.…”

Section: Discussionmentioning

confidence: 73%

Mindfulness in Motion and Dietary Approaches to Stop Hypertension (DASH) in Hypertensive African Americans

Wright

Klatt

Adams

et al. 2020

J American Geriatrics Society

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Objectives Hypertension increases the risk of developing Alzheimer's disease or related dementias. This pilot study's purpose was to examine the feasibility and acceptability of a novel intervention, Mindfulness in Motion (MIM) and Dietary Approaches to Stop Hypertension DASH (MIM DASH), to improve diet, mindfulness, stress, and systolic blood pressure (BP) in older African Americans with mild cognitive impairment (MCI) and hypertension. Design Cluster randomized controlled trial. Setting Intergenerational community center in a large metropolitan area. Participants African Americans with MCI and hypertension. Participants were divided into six groups randomized 1:1:1 to the MIM DASH group, attention only (non‐hypertensive education) group, or true control group. The MIM DASH and attention only interventions were delivered in 8‐weekly 2 hour group sessions. MIM included mindful movements from chair/standing, breathing exercises, and guided meditation. The DASH component used a critical thinking approach of problem solving, goal setting, reflection, and self‐efficacy. The true control group received a DASH pamphlet at the end. Measurements Feasibility was tracked through enrollment and attendance records; acceptability was assessed through interviews. Blood pressure was measured using the Omron HEM‐907XL Monitor. Dietary intake was measured by DASH‐Q. Mindfulness was measured by the Cognitive and Affective Mindfulness Scale. Stress was measured by the Perceived Stress Scale. MCI was determined using the Self‐Administered Gerocognitive Examination. Data were collected at baseline and 3‐months. Results Median session attendance was six for the MIM DASH group and six for the attention only group. There were no changes in diet, mindfulness, or stress. There was a clinically significant reduction in systolic BP in the MIM DASH group (−7.2 mmHg) relative to the attention only group (−.7), and no change between the MIM DASH and true control groups. Conclusion Results indicate that the MIM DASH intervention was feasible and culturally acceptable in African Americans with hypertension and MCI.

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Section: Discussionmentioning

confidence: 73%

Mindfulness in Motion and Dietary Approaches to Stop Hypertension (DASH) in Hypertensive African Americans

Wright

Klatt

Adams

et al. 2020

J American Geriatrics Society

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“…Digital tools for health management included web-based programmes, [13][14][15][16][17][18][19][20][21][22][23][24][25] mobile phone apps or text messages 20 25-34 and wearables. [35][36][37][38] Community or face-to-face health programmes have been developed for or implemented in churches, 39 rural communities, 40 41 youth healthcare centres, 42 adult day-care centres, 43 paediatric practices, 44 assisted living facilities, 45 hospitals, [46][47][48] mobile health counselling units, 49 schools 50 and workplaces. [51][52][53] We used the model of Gambhir et al 1 to determine the stage in the precision health ecosystem that our reviewed articles focus on.…”

Section: Context and Characteristics Of Included Studiesmentioning

confidence: 99%

Trends and gaps in precision health research: a scoping review

et al. 2021

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ObjectiveTo determine progress and gaps in global precision health research, examining whether precision health studies integrate multiple types of information for health promotion or restoration.DesignScoping review.Data sourcesSearches in Medline (OVID), PsycINFO (OVID), Embase, Scopus, Web of Science and grey literature (Google Scholar) were carried out in June 2020.Eligibility criteriaStudies should describe original precision health research; involve human participants, datasets or samples; and collect health-related information. Reviews, editorial articles, conference abstracts or posters, dissertations and articles not published in English were excluded.Data extraction and synthesisThe following data were extracted in independent duplicate: author details, study objectives, technology developed, study design, health conditions addressed, precision health focus, data collected for personalisation, participant characteristics and sentence defining ‘precision health’. Quantitative and qualitative data were summarised narratively in text and presented in tables and graphs.ResultsAfter screening 8053 articles, 225 studies were reviewed. Almost half (105/225, 46.7%) of the studies focused on developing an intervention, primarily digital health promotion tools (80/225, 35.6%). Only 28.9% (65/225) of the studies used at least four types of participant data for tailoring, with personalisation usually based on behavioural (108/225, 48%), sociodemographic (100/225, 44.4%) and/or clinical (98/225, 43.6%) information. Participant median age was 48 years old (IQR 28–61), and the top three health conditions addressed were metabolic disorders (35/225, 15.6%), cardiovascular disease (29/225, 12.9%) and cancer (26/225, 11.6%). Only 68% of the studies (153/225) reported participants’ gender, 38.7% (87/225) provided participants’ race/ethnicity, and 20.4% (46/225) included people from socioeconomically disadvantaged backgrounds. More than 57% of the articles (130/225) have authors from only one discipline.ConclusionsAlthough there is a growing number of precision health studies that test or develop interventions, there is a significant gap in the integration of multiple data types, systematic intervention assessment using randomised controlled trials and reporting of participant gender and ethnicity. Greater interdisciplinary collaboration is needed to gather multiple data types; collectively analyse big and complex data; and provide interventions that restore, maintain and/or promote good health for all, from birth to old age.

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“…Designing CBCT programmes with input and developmental insights from cultural groups that they intend to serve allows the programmes to target relevant barriers and challenges, and resources to be applied where most needed 15 16. CBCT programmes have shown promising impacts on chronic disease awareness, condition management, medication adherence, programme satisfaction, condition-specific knowledge, psychosocial factors, and health intervention strategies among black communities 22 29–33. However, the design, structure and operational definition of CBCT programmes varies considerably from programme to programme, making them difficult to compare.…”

Section: Introductionmentioning

confidence: 99%

Community-based culturally tailored education programmes for black adults with cardiovascular disease, diabetes, hypertension and stroke: a systematic review protocol of primary empirical studies

et al. 2022

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IntroductionChronic conditions and stroke disproportionately affect black adults in communities all around the world partly due to patterns of systemic racism, disparities in care, and lack of resources. Culturally tailored programmes can potentially meet the needs of the communities they serve, including black adults who may experience reduced access to postacute services. To address unequal care received by black communities, a shift to community-based programmes that deliver culturally tailored programmes may give an alternative to a healthcare model which reinforces health inequities. The objectives of this review are to: (1) synthesise key programme characteristics and outcomes of culturally tailored community-based (CBCT) programmes that are designed to improve health outcomes in black adults with cardiovascular disease, hypertension, diabetes, or stroke and (2) identify which of the five categories of culturally appropriate programmes from Kreuter and colleagues have been used to implement CBCT programmes.Methods and analysisThis is a protocol for a systematic review that will search Medline, Embase and Cumulative Index to Nursing and Allied Health Literature databases to identify studies of CBCT programmes for black adults with cardiovascular disease, hypertension, diabetes, or stroke between 2000 and 2021. Two reviewers will assess each study based on the inclusion criteria and any disagreements will be resolved by a third reviewer. Data will be extracted using a customised data extraction form to identify programme characteristics and the strategies used to develop culturally appropriate programmes. AMSTAR will be used to evaluate the articles included in the study. The aggregated data will be presented through textual descriptions of programme characteristics and outcomes.Ethics and disseminationThis systematic review protocol does not require ethics approval without the inclusion of human participants and will use studies that have previously obtained informed consent. The systematic review findings will be disseminated in a peer-reviewed journal and used to inform future research led by JF and HS.Trial registration numberPROSPERO CRD42021245772.

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Exploring the intervention effect moderators of a cardiovascular health promotion study among rural African‐Americans

Abstract: Knowledge about the moderators that influenced intervention outcomes can assist public health nurses in tailoring health promotion programs for underserved populations that can be implemented in community settings.

Cited by 7 publications

References 36 publications

Mindfulness in Motion and Dietary Approaches to Stop Hypertension (DASH) in Hypertensive African Americans

Mindfulness in Motion and Dietary Approaches to Stop Hypertension (DASH) in Hypertensive African Americans

Trends and gaps in precision health research: a scoping review

Community-based culturally tailored education programmes for black adults with cardiovascular disease, diabetes, hypertension and stroke: a systematic review protocol of primary empirical studies

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