A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App

Brewer, LaPrincess C; Kumbamu, Ashok; Smith, Carl H.; Jenkins, Sarah M.; Jones, Clarence; Hayes, Sharonne N.; Burke, Lora E.; Cooper, Lisa A.; Patten, Christi A.

doi:10.2196/21450

Cited by 17 publications

(36 citation statements)

References 41 publications

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“…In a recent qualitative analysis of the FAITH! app pilot study, participants demonstrated that they received encouragement and social support toward a healthy lifestyle from posts by other participants on the sharing board [ 48 ]. Thus, facilitating opportunities for discussion among study participants through a sharing board feature may foster meaningful engagement in mHealth interventions and increase social support in mHealth lifestyle interventions.…”

Section: Discussionmentioning

confidence: 99%

“…The intervention was co-designed with African American community members from participating churches who could give voice to the daily lived experiences of African Americans to ensure that the intervention emphasized African American faith, spirituality, and social connectedness. This study implemented an mHealth lifestyle intervention that was well-aligned with smartphone use patterns in African Americans and one that was well-received by participants [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, changes in diet and PA self-regulation and perceived barriers to healthy diet and PA were assessed to determine how effectively the intervention addressed these components of the health belief model [ 42 ]. Community mobilization was leveraged with the involvement of community partners from participating African American churches in all stages of app design using a community-based participatory research approach to ensure that the app incorporated African American religious and spiritual beliefs, the social connectedness aspects of the African American church, and cultural traditions of the African American community [ 42 , 48 ]. African American churches have been the cornerstone of academic-community partnerships seeking to enact social justice through research to improve health and access to quality care among African Americans [ 49 ].…”

Section: Methodsmentioning

confidence: 99%

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Improvements in Diet and Physical Activity–Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study

Cyriac

Jenkins

Patten

et al. 2021

JMIR Mhealth Uhealth

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Background African Americans continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared with White people. Mobile health (mHealth) interventions are innovative platforms to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied among African Americans. Objective This study aims to examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in African Americans and whether these changes correlate with diet and PA behavioral change. Methods This study is a retrospective analysis evaluating changes in diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors (daily fruit and vegetable intake and moderate-intensity PA [MPA] per week) in 45 African American adults (mean age 48.7 years, SD 12.9 years; 33/45, 73% women) enrolled in the FAITH! (Fostering African American Improvement in Total Health) app pilot study. The intervention is a 10-week, behavioral theory–informed, community-based mHealth lifestyle intervention delivered through a mobile app platform. Participants engaged with 3 core FAITH! app features: multimedia education modules focused on CVH with self-assessments of CVH knowledge, self-monitoring of daily fruit and vegetable intake and PA, and a sharing board for social networking. Changes in self-reported diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors were assessed by electronic surveys collected at baseline and 28 weeks postintervention. Changes in diet and PA-related psychosocial factors from pre- to postintervention were assessed using paired 2-tailed t tests. The association of changes in diet and PA-related psychosocial variables with daily fruit and vegetable intake and MPA per week was assessed using Spearman correlation. Associations between baseline and 28-week postintervention changes in diet and PA-related psychosocial measures and CVH behaviors with covariates were assessed by multivariable linear regression. Results Participants reported improvements in 2 subscales of diet self-regulation (decrease fat and calorie intake, P=.01 and nutrition tracking, P<.001), one subscale of social support for healthy diet (friend discouragement, P=.001), perceived barriers to healthy diet (P<.001), and daily fruit and vegetable intake (P<.001). Improvements in diet self-regulation (increase fruit, vegetable, and grain intake, and nutrition tracking) and social support for healthy diet (friend encouragement) had moderate positive correlations with daily fruit and vegetable intake (r=0.46, r=0.34, and r=0.43, respectively). A moderate negative correlation was observed between perceived barriers to healthy diet and daily fruit and vegetable intake (r=−0.25). Participants reported increases in PA self-regulation (P<.001). Increase in social support subscales for PA (family and friend participation) had a moderate positive correlation with MPA per week (r=0.51 and r=0.61, respectively). Conclusions Our findings highlight key diet and PA-related psychosocial factors to target in future mHealth lifestyle interventions aimed at promoting CVH in African Americans.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Improvements in Diet and Physical Activity–Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study

Cyriac

Jenkins

Patten

et al. 2021

JMIR Mhealth Uhealth

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“…Among 724 veterans with CHD with access to mobile technologies, enrolled in a home-based virtual CR program, there were no differences in CR participation and completion by race [ 83 ]. Additionally, a mobile application that was tailored to African American patient preferences was successful in improving cardiovascular health behaviors [ 84 ]. Future research is needed to refine home-based CR to include technology that is accessible and tailored to African Americans and other minority patients.…”

Section: Novel Cr Delivery Modalitiesmentioning

confidence: 99%

Disparities in the Use of Cardiac Rehabilitation in African Americans

Mathews

Akhiwu

Mukherjee

et al. 2022

Curr Cardiovasc Risk Rep

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Purpose of review Cardiac rehabilitation (CR) is a comprehensive outpatient program that reduces the risk of mortality and recurrent events and improves functional status and quality of life for patients recovering from acute cardiovascular disease (CVD) events. Among individuals with established CVD, African Americans have a higher risk of major cardiac events, which underscores the importance of CR use among African Americans. However, despite their high likelihood of adverse outcomes, CR is poorly utilized in African Americans with CVD. We review data on CR utilization among African Americans, barriers to participation, and the implications for policy and practice. Recent findings Although established as a highly effective secondary prevention strategy, CR is underutilized in general, but especially by African Americans. Notwithstanding efforts to increase CR participation among all groups, participation rates remain low for African Americans and other minorities compared to Non-Hispanic Whites. The low CR participation rates by African Americans can be attributed to an array of factors including differential referral patterns, access to care, and socioeconomic factors. There are several promising strategies to improve CR participation which include promoting evidence-based guidelines, reducing barriers to access, novel CR delivery modalities, including more African Americans in CR clinical research, and increasing diversity in the CR workforce. Summary African Americans with CVD events are less likely to be referred to, enroll in, and complete CR than Non-Hispanic Whites. There are many factors that impact CR participation by African Americans. Initiatives at the health policy, health system, individual, and community level will be needed to reduce these disparities in CR use.

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“…10 , 11 Thus smartphone-based lifestyle interventions can be effective platforms to address these CVH disparities in AAs, but require the use of a community-engaged, and user-centered approach to develop successful interventions. 9 , 12 – 14 There has been a lag in the widespread adoption of evidence-based, community-based participatory research (CBPR) approaches to build equitable community–academic partnerships with AA communities. These approaches have been shown to be effective in recruiting historically underrepresented and marginalized racial/ethnic minority groups into clinical research using culturally tailored recruitment strategies.…”

Section: Introductionmentioning

confidence: 99%

Sign of the times: Community engagement to refine a cardiovascular mHealth intervention through a virtual focus group series during the COVID-19 Pandemic

et al. 2022

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Background African-Americans are underrepresented in mobile health intervention research studies which can perpetuate health inequities and the digital divide. A community-based, user-centered approach to designing mobile health interventions may increase their sociocultural relevance and effectiveness, especially with increased smartphone use during the coronavirus disease 2019 pandemic. We aimed to refine an existing mobile health intervention via a virtual focus group series. Methods African-American community members (n = 15) from churches in Minneapolis-St. Paul and Rochester, Minnesota were enrolled in a virtual (via videoconferencing), three-session focus group series over five months to refine a cardiovascular health-focused mobile health application (FAITH! [Fostering African-American Improvement in Total Health!] App). Participants accessed the app via their smartphones and received a Fitbit synced to the app. Participants engaged with multimedia cardiovascular health-focused education modules, a sharing board for social networking, and diet/physical activity self-monitoring. Participant feedback on app features prompted iterative revisions to the FAITH! App. Primary outcomes were app usability (assessed via Health Information Technology Usability Evaluation Scale range: 0–5) and user satisfaction. Results Participants (mean age [SD]: 56.9 [12.3] years, 86.7% female) attended a mean 2.8 focus groups (80% attended all sessions). The revised FAITH! App exceeded the goal Health Information Technology Usability Evaluation Scale score threshold of ≥4 (mean: 4.39, range: 3.20–4.95). Participants positively rated updated app content, visual appeal, and use of social incentives to maintain engagement. Increasing user control and refinement of the moderated sharing board were identified as areas for future improvement. Conclusions Community-partnered, virtual focus groups can optimize usability and increase participant satisfaction of mobile health lifestyle interventions that aim to promote cardiovascular health in African-Americans.

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A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App

Cited by 17 publications

References 41 publications

Improvements in Diet and Physical Activity–Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study

Improvements in Diet and Physical Activity–Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study

Disparities in the Use of Cardiac Rehabilitation in African Americans

Sign of the times: Community engagement to refine a cardiovascular mHealth intervention through a virtual focus group series during the COVID-19 Pandemic

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