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.

项目概要/摘要 与所有种族/族裔群体相比，非裔美国人 (AA) 成年人的心血管健康状况最低 (CVH) 评分由美国心脏协会 (AHA) Life's Essential 8（LE8；由研究 PI 共同开发）得出 导致了心血管疾病死亡率差异。LE8 指标包括 4 种健康行为和 4 种行为。 临床因素（例如饮食、体力活动 [PA]、睡眠、血压等）。 赞同整合社会文化相关的移动医疗 (mHealth) 干预措施，以促进 CVH 通过利用社会资本和跨部门合作来改善服务不足的人群 然而，这方面的工作还很缺乏。 利用现有的有效、文化相关、基于证据的干预措施！ 非裔美国人整体健康改善！）计划，一个已建立的基于社区的参与性计划 在研究 (CBPR) 工作中，我们与 AA 社区共同设计了一种根据文化量身定制的 CVH mHealth 干预措施 随后，社区知情的 FAITH! 应用程序在 NIMHD 资助的随机临床试验中进行了测试。 (RCT)，FAITH! 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 教会 (MSP)，明尼苏达州。我们的研究发现 FAITH! 应用程序显着改善了 CVH 分数和行为。 （饮食、PA）..参与者认为该应用程序对于 CVH 教育来说是公平的，并建议整合 我们的主要目标是让 AA 教会参与推广 CVH 和 数字健康（equityDHE，“Techquity”）和这些社区内的数字健康准备情况 设计了 DHE 工具包和数字健康倡导者 (DHA) 网络。 P50 NOSI 补充提案与 NIMHD 健康差异研究框架一致，因为 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 3 个目标：目标 1。 我们将与 AA 教会共同设计一个与文化相关的 DHE 工具包。 由 20 名 AA 社区成员组成的焦点小组系列的流程，主要成果是工具包的可接受性和有效性。 目标 2 将对 20 名 DHA 进行数字健康准备和 CVH 推广方面的培训，以便融入 移动医疗干预。目标 3 将评估社区知情的移动医疗干预的影响（FAITH！应用程序） DHA 通过对 150 名 AA 成年人进行的整群随机对照试验，对 AA 成年人的 CVH 提供支持。 从基线到随机化后 6 个月的 LE8 评分次要结果包括数字健康。 准备情况和心理社会措施（社会支持、自我调节和健康生活方式的障碍）。 成立的社区指导委员会将为所有活动提供意见，我们的项目具有创新性。 多层次策略包括 DHE 工具包的参与式设计、科学合理的 DHA 培训和整合 基于行为理论、经验支持的 mHealth 生活方式干预措施来影响 CVH 和 DHE 如果成功，我们的结果可以为使用基于证据的移动医疗工具来促进发展铺平道路。 最佳 CVH，同时解决 AA 之间的数字鸿沟。