Promoting cardiovascular health and wellness among African-Americans: Community participatory approach to design an innovative mobile-health intervention

Abstract

Background Despite improvements in mortality rates over the past several decades, cardiovascular (CV) disease remains the leading cause of death for African-Americans (AAs). Innovative approaches through mobile health (mHealth) interventions have the potential to support lifestyle change for CV disease prevention among AAs. We aimed to translate a behavioral theory–informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for AAs. We describe the design and development of a culturally relevant, CV health and wellness digital application (app) and pilot testing using a community-based participatory research (CBPR) approach with AA churches. Methods This mixed methods study used a 4-phase iterative development process for intervention design with the AA community. Phase 1 included focus groups with AA community members and church partners (n = 23) to gain insight regarding potential app end user preferences. In Phase 2, the interdisciplinary research team synthesized Phase 1 input for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with church partners (n = 13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4, a single group pilot study among AA church congregants (n = 50), assessed app acceptability, usability, and satisfaction. Results Phase 1 focus groups indicated general and health-related apps preferences: multifunctional, high-quality graphics/visuals, evidence-based, yet simple health information and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Phase 3 feedback was used to refine the app prototype for pilot testing. Phase 4 pilot testing indicated high app acceptability, usability, and satisfaction. Conclusions This study illustrates integration of formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities among AAs. Given the positive app perceptions, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities. Trial registration Clinicaltrials.gov NCT03084822 .

Emergency Preparedness and Risk Communication Among African American Churches: Leveraging a Community-Based Participatory Research Partnership COVID-19 Initiative

“…9 Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota. 10 Division of Community Internal Medicine, Mayo Clinic, Jacksonville, Florida. 11 Department of Family Medicine, Mayo Clinic, Rochester, Minnesota.…”

“…(Fostering African-American Improvement in Total Health) program is the first academic-community partnership between Mayo Clinic and local African American churches. It forged an authentic, community-based participatory research (CB-PR) initiative to diminish chronic disease health disparities, particularly cardiovascular disease, in disproportionately affected African American communities (10). Since its founding in 2013 in Minnesota, FAITH!…”

“…In 2017, FAITH! established a Community Steering Committee as a governing advisory board comprising diverse community advocacy and public health leaders to guide its programming (10).…”

“…Through community engagement and a social contextual framework, FAITH! has implemented innovative, community-driven programs, including signature mobile health lifestyle interventions ( 11 ). In 2017, FAITH!…”

Addressing Cardiovascular Health Disparities in Minnesota: Establishment of a Community Steering Committee by FAITH! (Fostering African-American Improvement in Total Health)

“…Many activities and accomplishments have resulted from utilization of the guiding CBPR model (Figure 4). Alongside the co-leaders, CSC members have reviewed study protocols, co-authored manuscripts [10,13,28,29,30,31], and been involved in applying for, reviewing, and securing grants [10,32,33,34]. Members have also been heavily involved with FAITH!…”