BACKGROUND
African Americans (AAs) continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared to Whites. Mobile health (mHealth) interventions are a novel platform to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied and underutilized among AAs.
OBJECTIVE
To examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in AAs and whether these changes correlate with changes in diet and PA behaviors.
METHODS
This study is a retrospective analysis evaluating changes in diet and PA-related psychosocial measures (diet and PA self-regulation, perceived barriers to healthy diet and PA) and behaviors (fruit/vegetable intake, PA) in 45 AA adults (mean age 48.7 [SD 12.9], 73% women) enrolled in the FAITH! App Pilot Study. The intervention is a 10-week, behavioral-theory informed, community-based mHealth lifestyle intervention delivered through a mobile application (app) platform (FAITH! App) that provided participants opportunities to engage with 10 core multimedia education modules focused on CVH, self-assessments of CVH knowledge, a sharing board for social networking, and self-monitoring of daily fruit/vegetable intake and PA. Changes in self-reported diet and PA-related psychosocial variables and behaviors were assessed by electronic surveys collected at baseline and 28-weeks post-intervention. Changes were analyzed in the overall cohort and explored within subgroups based on socio-demographics, baseline electronic health literacy (EHL), and app engagement. Statistical analysis of pre- and post-intervention changes within and between groups were performed via rank-based tests, and correlation of changes between fruit/vegetable intake and PA were assessed via Spearman correlation.
RESULTS
The overall sample reported decreases in perceived barriers to healthy diet (P<.0001) and improvements in components of diet self-regulation (i.e., fat/calorie intake [P=.01], nutrition tracking [P<.0001]). Improvements in diet self-regulation (increase fruit/vegetable intake, nutrition tracking) had moderate positive correlation to fruit/vegetable intake (r=0.46, r=0.34 respectively). A moderate negative correlation was seen between perceived barriers to healthy diet and fruit/vegetable intake (r=-0.25). Overall, increases in PA self-regulation were observed. No meaningful correlations were found between PA-related psychosocial factors and PA. Subgroup analyses showed improvements in diet and PA self-regulation, perceived barriers to healthy diet, and fruit/vegetable intake among women, those with employment, higher app engagement, and eHealth literacy (all P≤.01).
CONCLUSIONS
Our findings suggest key diet and PA-related psychosocial factors to potentially target in future mHealth lifestyle interventions aiming to achieve CVH equity in AAs.
CLINICALTRIAL
clinicaltrials.gov [NCT03084822]
Improving Cardiovascular Health Among African-Americans Through Mobile Health: the FAITH! App Pilot Study
