The Role of Social Support in Cardiovascular Clinical Trial Participation among Black Men: Black Impact

Abstract

Background: Attainment of the American Heart Association’s Life’s Simple 7 (LS7) metrics reduces cardiovascular disease (CVD) risk; yet, Black Americans have the lowest LS7 attainment among all communities, the highest rate of CVD mortality, and low clinical trial participation. Social support is positively correlated with chronic disease self-management. Here, we describe the role of social support in a single-arm pilot clinical trial of a community-based lifestyle intervention among Black American men. Methods: The 24-week intervention featured weekly team-based physical activity and LS7-themed education. Seventy-four Black men participated in the intervention; twenty agreed to participate in exit surveys via one of three semi-structured focus groups. Data were transcribed verbatim and analyzed using content analysis framed by House’s social support framework. Results: Participants reported support from both peers and health coaches. The sub-themes of social support among peers were: (1) acknowledgement, understanding, and validation, (2) inspiration, (3) sense of community, (4) fear of disappointing fellow participants, and (5) group synergy. The sub-themes of social support from the health coaches and study team staff included: (1) contemplation of current health status, (2) racial concordance of health coaches and study team staff, (3) investment of the research team, (4) incentives, (5) access to healthcare providers, and (6) the COVID-19 pandemic. Emotional support was the most frequently discussed theme. Conclusions: Social support, especially emotional support, from peers and health coaches was a driver of clinical trial participation among participants. The intervention created a positive social environment and decreased medical mistrust. This intervention may provide a framework by which to facilitate clinical trial participation among Black men.

More than Just a Number: Perspectives from Black Male Participants on Community-Based Interventions and Clinical Trials to Address Cardiovascular Health Disparities

“…Engaging key stakeholders was a critical component of community engagement, given that focusing solely on clinical trial recruitment without any input or cooperation from community members may have proven less successful [42]. Though the partnership was beneficial, many Black men queried reported that interpersonal relationships between the other men participating in the trial and members of the research team built their confidence to participate in the study [43]. For several others, this rapport spoke to the benevolent intent of the research team, which likely had an essential role in reducing the mistrust associated with clinical trials among Black men.…”

“…After participants have been enrolled in the study, promoting camaraderie and fellowship becomes paramount for building trust and encouraging active participation. This imperative was acknowledged and effectively addressed in the Black Impact study through the implementation of strategies aimed at bolstering social support [43]. By organizing teams based on residence, the study encouraged regular interaction among participants, extending beyond the scheduled in-person study sessions.…”