Techquity by FAITH!: A cluster randomized controlled trial to assess the efficacy of a community-informed, cardiovascular health promotion mobile hlth intervention with digital health advocate support

Techquity by FAITH!：一项整群随机对照试验，旨在评估社区知情、心血管健康促进移动 hlth 干预措施在数字健康倡导者支持下的效果

• 批准号: 10891016
• 负责人: MICHELE L ALLEN
• 金额: $ 77.78万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10891016
• 关键词: Address; Adult; Advocacy; Advocate; African American; American; American Heart Association; Behavior; Behavioral; Blood Pressure; COVID-19 pandemic; Cardiovascular Diseases; Church; Clinical; Clinical Research; Collaborations; Communities; Community Health; Competence; Development; Diet; Disparity; Environment; Equity; Ethnic Population; Evidence based intervention; Faith; Faith leader; Feedback; Focus Groups; Fostering; Funding; Goals; Health; Health Disparities Research; Health Promotion; Health Promotion and Education; Health Technology; Health behavior; Health education; Healthcare; Informal Social Control; Intervention; Learning; Life; Measures; Methods; Minnesota; Modeling; National Institute on Minority Health and Health Disparities; Nature; Participant; Personal Satisfaction; Persons; Phase; Physical activity; Population; Process; Qualitative Research; Randomized; Randomized, Controlled Trials; Readiness; Research; Resources; Risk Factors; Saints; Series; Sleep; Social Network; Social support; Structural Racism; Structure; Technology; Testing; Training; Treatment Efficacy; Underserved Population; Update; arm; cardiovascular health; community based participatory research; design; digital; digital health; digital technology; eHealth; efficacy evaluation; evidence base; follow-up; health determinants; health disparity; health equity; health inequalities; health literacy; healthy lifestyle; improved; innovation; lifestyle intervention; literacy; mHealth; meetings; member; mortality disparity; primary outcome; programs; psychosocial; racial population; randomized, clinical trials; satisfaction; secondary outcome; skills; smartphone application; social; social capital; social culture; sound; support network; theories; tool; usability

PROJECT SUMMARY/ABSTRACT Compared to all racial/ethnic groups, African-American (AA) adults have the lowest cardiovascular health (CVH) scores by the American Heart Association (AHA) Life's Essential 8 (LE8; co-developed by study PI), which has resulted in cardiovascular disease mortality disparities. The LE8 metric includes 4 health behaviors and 4 clinical factors (eg, diet, physical activity [PA], sleep, blood pressure, etc). To address CVH disparities, AHA endorses integrating socioculturally relevant, mobile health (mHealth) interventions to promote CVH among underserved populations by leveraging social capital and cross-sector collaboration. However, there is a paucity of effective, culturally relevant, evidence-based interventions available. Leveraging the FAITH! (Fostering African-American Improvement in Total Health!) Program, an established community-based participatory research (CBPR) effort, we co-designed a culturally tailored, CVH mHealth intervention alongside AA community members. The community-informed FAITH! App was then tested in an NIMHD-funded randomized clinical trial (RCT), the FAITH! Trial, among participants (N=85) from AA churches in Rochester and Minneapolis-Saint Paul (MSP), MN. Our study found the FAITH! App resulted in significant improvements in CVH scores and behaviors (diet, PA).. Participants viewed the app as equitable for CVH education, and suggested integrating digital/technical support to enhance app features. Our major goal is to engage AA churches to promote CVH and digital health equity (DHE, “Techquity”) and digital health readiness within these communities through a co- designed DHE toolkit and Digital Health Advocates (DHAs) network. The P50 NOSI supplement proposal aligns with the NIMHD Health Disparities Research Framework as it addresses the multi-faceted nature of CVH disparities and digital health inequities. We propose 3 aims: Aim 1 engagesAA churches to co-design a culturally relevant DHE toolkit. We will use a formative/qualitative research process in a focus group series with 20 AA community members. Primary outcomes are toolkit acceptability and satisfaction. Aim 2 will train 20 DHAs in digital health readiness and CVH promotion for integration into an mHealth intervention. Aim 3 will assess the impact of a community-informed, mHealth intervention (FAITH! App) with DHA support on CVH among AA adults through a cluster RCT of 150 AA adults. Primary outcome is change in LE8 score from baseline to 6-months post-randomization. Secondary outcomes include digital health readiness and psychosocial measures (social support, self-regulation, and perceived barriers to healthy lifestyle). An established community steering committee will provide input for all activities. Our project is innovative as our multilevel strategy includes participatory design of a DHE toolkit, scientifically sound DHA training and integration of a behavioral theory-informed, empirically-supported mHealth lifestyle intervention to influence CVH and DHE among AAs. If successful, our results can pave the way for use of evidence-based mHealth tools to promote optimal CVH while addressing the digital divide among AAs.

项目摘要/摘要 与所有种族/族裔群体相比，非洲裔美国人（AA）成年人的心血管健康水平最低 (CVH)美国心脏协会（AHA）Life's Essential 8（LE 8;由研究PI共同开发）的评分， 导致了心血管疾病死亡率的差异。LE 8指标包括4种健康行为和4种 临床因素（如饮食、体力活动[PA]、睡眠、血压等）。为了解决CVH差异，AHA 支持整合社会文化相关的移动的健康（mHealth）干预措施， 通过利用社会资本和跨部门合作，帮助得不到充分服务的人口。然而， 有效的、与文化相关的、以证据为基础的干预措施。信仰的力量！（培养 非裔美国人整体健康状况的改善！）计划，一个建立在社区基础上的参与性 研究（CBPR）的努力，我们共同设计了一个文化定制，CVH mHealth干预与AA社区 成员社区的信仰！然后在NIMHD资助的随机临床试验中对应用程序进行测试 (RCT)信仰！试验，参与者（N=85）来自罗切斯特和明尼阿波利斯-圣保罗的AA教堂 (MSP)，MN.我们的研究找到了信仰！应用程序显著改善了CVH评分和行为 (diet，PA）..参与者认为该应用程序对CVH教育是公平的，并建议整合 数字/技术支持，以增强应用程序的功能。我们的主要目标是让AA教会参与促进CVH， 数字健康公平（DHE，“Techquity”）和数字健康准备在这些社区通过共同的， 设计DHE工具包和数字健康倡导者（DHAs）网络。 P50 NOSI补充提案与NIMHD健康差异研究框架保持一致， 它解决了CVH差异和数字健康不平等的多方面性质。我们提出三个目标：目标1 鼓励AA教会共同设计一个与文化相关的DHE工具包。我们将使用形成性/定性研究 与20名AA社区成员一起进行焦点小组系列讨论。主要结果是工具包的可接受性， 满意目标2将在数字健康准备和CVH推广方面培训20名DHA， 移动健康干预。目标3将评估社区知情的移动健康干预措施的影响（信念！应用程序） 通过150名AA成人的随机对照试验，在AA成人中使用DHA支持治疗CVH。主要结果是变化 从基线至随机化后6个月的LE 8评分。次要成果包括数字健康 准备和心理社会措施（社会支持，自我调节和健康生活方式的感知障碍）。 一个已设立的社区指导委员会将为所有活动提供投入。我们的项目是创新的， 多层次战略包括参与性地设计DHE工具包、科学合理的DHA培训和整合 一个行为理论知情的，医疗支持的mHealth生活方式干预，以影响CVH和DHE 在AA之间。如果成功，我们的研究结果可以为使用循证移动健康工具铺平道路， 最佳的CVH，同时解决AA之间的数字鸿沟。