Community-Based Culturally Tailored Education Programs for Black Communities with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: Systematic Review Findings

Abstract

Background Community-based culturally tailored education (CBCTE) programs for chronic diseases may reduce health disparities; however, a synthesis across chronic diseases is lacking. We explored (1) the characteristics and outcomes of CBCTE programs and (2) which strategies for culturally appropriate interventions have been used in CBCTE programs, and how they have been implemented. Methods A systematic review was conducted by searching three databases to identify empirical full-text literature on CBCTE programs for Black communities with cardiovascular disease, hypertension, diabetes, or stroke. Studies were screened in duplicate, then data regarding study characteristics, participants, intervention, and outcomes were extracted and analyzed. Cultural tailoring strategies within programs were categorized using Kreuter and colleagues’ framework. Results Of the 74 studies, most were conducted in the USA (97%) and delivered in one site (53%; e.g., church/home). CBCTE programs targeted diabetes (65%), hypertension (30%), diabetes and hypertension (1%), cardiovascular disease (3%), and stroke (1%). Reported program benefits included physiological, medication-related, physical activity, and literacy. Cultural tailoring strategies included peripheral (targeted Black communities), constituent-involving (e.g., community informed), evidential (e.g., integrated community resources), linguistic (e.g., delivered in community’s dialect/accent), and sociocultural (e.g., integrated community members’ religious practices). Conclusions CBCTE programs may have beneficial outcomes, but a small sample size limited several. The strategies identified can be adopted by programs seeking to culturally tailor. Future interventions should clearly describe community members’ roles/involvement and deliver programs in multiple locations to broaden reach. Trial Registration PROSPERO CRD42021245772.

“A cuff is not enough”: A community‐based participatory research approach to soliciting perspectives of African Americans with hypertension and their family members on self‐management intervention features

“…Indeed, even participants' references to community-based recruitment and engagement emphasized the role of family as community and family's role in increasing intervention acceptability. A family-based intervention reflects a culturally tailored approach to providing hypertension education and self-management support and is specifically a sociocultural strategy to cultural appropriateness (Kreuter et al, 2003) that positions discussions of hypertension and wellbeing in the social context and cultural values of persons racialized as Black or African American (Singh et al, 2022). Further, the family-level impact suggested by participants is supported in the literature: for example, Thornton et al (2019) found that African American adults' participation in a hypertension self-management intervention resulted in family-level changes to meal preparation and the food environment of the home and that role modeling healthy dietary behavior may benefit the healthy eating behaviors of coresidential adolescent children.…”

A importância da educação cardiovascular em programas de prevenção primária: uma revisão abrangente e análise de eficácia

“…No âmbito da educação cardiovascular, o foco principal reside em programas de educação cardiovascular comunitária (CBCTE), culturalmente adaptados, que são especificamente concebidos para satisfazer as complexas necessidades de saúde de adultos negros que sofrem de condições como doenças cardiovasculares, hipertensão, diabetes ou acidente vascular cerebral [6]. Estes programas adotam uma abordagem abrangente, enfatizando a importância de adaptar as intervenções para se alinharem às circunstâncias únicas de cada indivíduoincluindo as suas preferências alimentares, objetivos de saúde, rotinas de medicação e as barreiras que enfrentam devido às suas experiências de vida específicas [6].…”

“…Ao fazê-lo, os programas CBCTE visam elaborar uma estratégia educativa mais personalizada e eficaz que ressoe com os participantes a um nível mais profundo, aumentando assim o seu envolvimento e o potencial para melhores resultados de saúde [6]. Além disso, estes programas prestam especial atenção aos determinantes sociais da saúde, reconhecendo que factores como os níveis de rendimento e a educação podem influenciar significativamente a capacidade de um indivíduo para gerir as suas condições de saúde [6].…”

“…Ao fazê-lo, os programas CBCTE visam elaborar uma estratégia educativa mais personalizada e eficaz que ressoe com os participantes a um nível mais profundo, aumentando assim o seu envolvimento e o potencial para melhores resultados de saúde [6]. Além disso, estes programas prestam especial atenção aos determinantes sociais da saúde, reconhecendo que factores como os níveis de rendimento e a educação podem influenciar significativamente a capacidade de um indivíduo para gerir as suas condições de saúde [6]. Por exemplo, certas iniciativas CBCTE podem centrar-se em indivíduos com baixos rendimentos, que muitas vezes enfrentam maiores desafios no acesso aos recursos de saúde, ou podem limitar a participação àqueles com formação educacional específica para garantir que o conteúdo do programa seja acessível e útil para o público-alvo [ 6].…”