Health Freedom Path to Wellness: A Culturally-Relevant and Patient-Centered mHealth Intervention to Promote Cardiovascular Health Equity

健康自由之路的健康：一种与文化相关且以患者为中心的移动医疗干预措施，以促进心血管健康公平

• 批准号: 10303552
• 负责人: Aqueasha Martin Hammond
• 金额: $ 25.87万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-21 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10303552
• 关键词: Address; Adherence; Adult; African American; Behavior; Behavior Therapy; Behavioral; Behavioral Medicine; Blood Pressure Monitors; COVID-19 pandemic; Cardiology; Cardiovascular Diseases; Caring; Chronic Disease; Communities; Complex; Decision Making; Development; Diabetes Mellitus; Discipline of Nursing; Disease Outcome; Economics; Education; Educational Intervention; Educational workshop; Effectiveness; Ensure; Feasibility Studies; Freedom; Friends; General Population; Goals; Habits; Health; Health Food; Health Services; Health Technology; Health education; Healthcare Systems; Home Blood Pressure Monitoring; Hypertension; Individual; Informatics; Intervention; Interview; Kidney Diseases; Life Style; Low income; Medical; Methods; Mission; Mobile Health Application; Morbidity - disease rate; Obesity; Outcome; Participant; Patient Education; Patients; Perception; Persons; Pharmaceutical Preparations; Phase; Physical activity; Population; Process; Protocols documentation; Publishing; Research; Research Design; Risk Factors; Risk Reduction; Self Care; Self Management; Social support; Structure; Subgroup; System; Testing; United States National Institutes of Health; Urban Community; base; burden of illness; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; community based participatory research; computer human interaction; contextual factors; design; disability; disease disparity; disorder control; education access; evidence base; evidence based guidelines; experience; good diet; health care quality; health communication; health data; health disparity; health equity; heuristics; human centered computing; informatics tool; mHealth; mortality; patient oriented; patient-clinician communication; preference; programs; prototype; racial disparity; satisfaction; sociodemographics; socioeconomics; therapy design; tool; usability; user centered design; virtual

ABSTRACT Despite decades of recognition, African Americans (AAs) and adults living in urban communities continue to experience disproportionately higher rates of cardiovascular diseases (CVD) and associated risk factors, such as hypertension, diabetes, obesity, and kidney disease, than their representation in the general population. As the leading cause of mortality in the US and worldwide, CVD also causes serious morbidity, disability, and economic losses. AAs and adults living in low-income and urban communities represent particularly vulnerable subgroups of persons burdened by major CVD risk factors and experience poorer health outcomes. These health disparities in CVD burden and outcomes are influenced by complex sociodemographic, socioeconomic, healthcare system, and community factors, including patient self-management behaviors, utilization and quality of health services, provider-patient communication, healthy food availability, education, and social support. Effective strategies for CVD risk reduction and self-management behaviors include self-blood pressure (BP) monitoring, lifestyle changes (including healthy diet and physical activity habits), adherence to medications, and shared medical decision-making. These strategies represent a cornerstone of recommended care for CVD risk reduction and have been associated with significant improvements in CVD control among treated patients. Our primary study goal is to adapt an existing evidence-based, face-to-face, CVD educational and behavioral strategy intervention, the Health Freedom Circle of Friends program, into a mobile health (mHealth) intervention. The two-phase project will use principles of community-based participatory research (CBPR), human-centered computing, and personal informatics to develop a culturally-sensitive educational and behavioral mHealth intervention to promote CVD risk reduction and self-management behaviors among AAs and other groups disproportionately burdened by CVD (phase 1) and later test the mHealth intervention’s acceptability, usability, and satisfaction among key stakeholders (phase 2). We will use a mixed-methods, user-centered design approach to identify goals, needs, challenges, and preferences for participating in the culturally-sensitive, community-based mHealth personal informatics tool to promote CVD health equity. Aim 1 will establish patients’ needs and preferences for a community-based mHealth intervention tool to support CVD prevention and self-management using semi-structured interviews. Aim 2 will design a culturally-sensitive mHealth intervention prototype and tailor content using an iterative process within sequential in-person participatory design workshops. Aim 3 will assess the acceptability, usability, and satisfaction of the mHealth tool within a feasibility study among AAs and other groups disproportionately burdened by CVD. Our existing community stakeholder advisory board will provide input throughout all study phases. Our proposed study will contribute to the NIH’s mission to design and test culturally-sensitive mHealth tools for CVD health equity.

抽象的 尽管获得了数十年的认可，但非裔美国人（AAS）和居住在城市社区的成年人仍在继续 心血管疾病（CVD）和相关危险因素的比例不成比例的较高率 作为高血压，糖尿病，肥胖和肾脏疾病，其代表在一般人群中。作为 在美国和全球死亡的主要原因，CVD还引起严重的发病率，残疾和 经济损失。居住在低收入和城市社区的AAS和成人特别脆弱 由主要的CVD风险因素烧毁的人群亚组，健康结果较差。这些 CVD Burnen中的健康分布和结果受到复杂的社会人口统计学，社会经济， 医疗保健系统和社区因素，包括患者自我管理行为，利用率和质量 卫生服务，提供者与患者的沟通，健康食品可用性，教育和社会支持。 CVD风险降低和自我管理行为的有效策略包括自我压力（BP） 监测，生活方式的改变（包括健康的饮食和身体活动习惯），遵守药物， 并分享医疗决策。这些策略代表了推荐护理CVD的基石 降低风险，与治疗患者之间CVD控制的显着改善有关。 我们的主要学习目标是调整现有的循证，面对面的CVD教育和行为 战略干预，《朋友的健康自由圈计划》，进入移动健康（MHealth） 干涉。两阶段项目将使用基于社区的参与研究原则（CBPR）， 以人为本的计算和个人信息，以发展对文化敏感的教育和 行为MHealth干预措施以促进AAS之间的CVD风险降低和自我管理行为 和其他团体不成比例地被CVD烧毁（第1阶段），然后测试MHealth干预措施 主要利益相关者之间的可接受性，可用性和满意度（第2阶段）。我们将使用混合方法， 以用户为中心的设计方法来识别参与目标，需求，挑战和偏好 具有文化敏感的，基于社区的MHealth个人信息性工具来促进CVD健康公平。目标1 将建立患者的需求和偏好，以支持CVD 使用半结构化访谈进行预防和自我管理。 AIM 2将设计对文化敏感的 MHealth干预原型和量身定制的含量，使用迭代过程 参与设计研讨会。 AIM 3将评估MHealth的可接受性，可用性和满意度 在AAS和其他组中可行性研究中，CVD燃烧的工具。我们的现有 社区利益相关者顾问委员会将在所有研究阶段提供意见。我们提出的研究将 为NIH设计和测试对CVD健康公平的文化敏感MHealth工具的贡献。