The role of behavioral science in addressing cardiovascular health disparities: A narrative review of efforts, challenges, and future directions.

Abstract

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States. Despite improvements in the prevention and treatment of CVD over the past 20 years, racial/ethnic minority groups including non-Hispanic Blacks, Hispanic/Latinos, and some Asian subgroups (e.g., Asian Indians, Filipinos) experience higher rates of CVD risk factors and morbidity and mortality from CVD than non-Hispanic Whites. Therefore, addressing cardiovascular health disparities is an immediate priority. Behavioral science can play an important role in reducing disparities by capitalizing on expertise in human behavior change, social determinants of health, and implementation science. In this narrative review, we describe the efforts made within behavioral science to address CVD health disparities. We review current interventions to reduce CVD health disparities and provide practical recommendations that can be used as the field moves forward.

The Feasibility of Make My Day—A Randomized Controlled Pilot Trial of a Stroke Prevention Program in Primary Healthcare

“…It is therefore important in a full-scale trial to consider additional strategies to recruit persons at risk for stroke in a way that better represents the study population. It may be helpful to examine studies that have successfully recruited hard-to-reach populations, through strategies such as using a flexible and continuously adapting recruitment strategy, combining methods such as using different and relevant forms of social media (e.g., Facebook), involving socio-culturally relevant gatekeepers in the community and/or in healthcare settings [50][51][52], and using respondent-driven sampling [53].…”

If not us, who? If not now, when? Paths forward in science, patient care, and training to maximize the impact of cardiovascular behavioral medicine.

“…Furthermore, we encourage the development, testing, and implementation of culturally adapted interventions and interventions involving community-based partnerships, as they will be essential to achieving our goals. In their review on the role of behavioral science in addressing cardiovascular health disparities, Chirinos and colleagues (2022) provide a research agenda to maximize the impact of our field’s future work in this area. We urge all CVBM investigators to carefully consider their practical recommendations.…”

“…These statements and reports underscore the needs to focus on health-risk behaviors for primary prevention, routine screening of patients for issues such as depression and anxiety, self-care behaviors to support optimal outcomes, and environmental issues subsumed under the social determinants of health. Earlier, the WHO described lifestyle as the major driver of chronic disease burden (World Health Organization, 2002; WHO Study Group on Diet Nutrition & Prevention of Noncommunicable Diseases & World Health Organization, 1990), and the INTERHEART study placed these factors more broadly within the person’s psychosocial and environmental context (Rosengren et al, 2004), points highlighted in this issue in the papers by Albanese et al, (Albanese et al, 2022) and Chirinos et al (2022).…”

Value, implementation, and opportunities for cardiovascular behavioral medicine: A special issue commentary.

“…For example, there are well-documented racial and ethnic disparities in CVD risk factors, morbidity, and mortality. Chirinos et al (2022) discuss the essential role that health psychologists can play in reducing such disparities by using expertise in implementation science, social determinants of health, and health behavior change. Their narrative review highlights ongoing efforts within behavioral science and makes specific recommendations that can accelerate the impact of CVBM.…”