The Development and Evaluation of Visual Communication Tools to Convey Parental and Intergenerational Cardiovascular Disease Risk and Evoke Lifestyle Behavior Change in Low-income Black Families

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PROJECT SUMMARY: Despite decades of research and growing public awareness, obesity affects Black children from low-income households disproportionately. This leads to disparities in obesity, cardiovascular disease, and several other co-morbidities in adulthood. Parents play an important role in obesity and cardiovascular disease prevention by shaping their child’s dietary and lifestyle behaviors early in life. However, Black parents from low-income households face numerous socioeconomic barriers. Parents from these communities seek tangible and practical lifestyle advice that can be implemented despite these barriers. While health care providers in the primary care setting are often tasked with providing this advice and empowering parents to implement lifestyle behavior change, they lack efficient, effective, culturally relevant, and engaging tools that can convey the intergenerational risk of obesity and cardiovascular disease and facilitate changes in lifestyle behaviors for all members of the family. My long term goal as an independent researcher is to improve child health outcomes through a career focused on reducing disparities in obesity and its comorbidities by designing family-centered, bio-behavioral interventions that evoke motivation to change, facilitate progression to actionable steps, and augment the maintenance of behavior change in families from low-income households and minority racial groups. The objective of this study is to develop, assess, and evaluate the acceptability, feasibility, and preliminary efficacy of two visual communication tools, that make use of a visual image (graphical versus illustrative) coupled with structured, culturally relevant, brief behavior change counseling, to convey CVD risk in Black parents with obesity who have a school-age child (6-11 years) and are from a low-income household. Specifically, this study aims to: (1) develop two visual communication tools via iterative focus groups with a) Black parents affected by obesity and b) primary care health care providers (HCPs); (2) determine the acceptability and feasibility of each visual communication tool during a simulated clinical encounter with Black parents and HCPs; and (3) determine the preliminary efficacy of the two visual communication tools on intention to change, perceived risk, knowledge of CVD risk, and short-term lifestyle behavior change in parents affected obesity compared to a standardized CVD risk score. My career development plan includes mentorship, formal coursework, and seminars in three focus areas: acquire skills in the development of visual communication tools to convey disease risk in a culturally relevant way; gain expertise in the clinical application of Motivational Interviewing through culturally relevant brief behavior change counseling; obtain competence in designing randomized controlled trials in family-based behavior change interventions. Results from this study will determine the most salient tool for this population which will be tested in a randomized controlled trial (R01) to determine the effect on lifestyle change in parents and their children.