Community-based Culturally Tailored Education Programs for Black Adults With Cardiovascular Disease, Diabetes, Hypertension, and Stroke: a Systematic Review Protocol

Abstract Background: Chronic conditions and stroke disproportionately affect Black adults in communities all around the world due patterns of systemic racism, disparities in care, and lack of resources. Culturally-tailored programs can meet the needs of the communities they serve, including Black adults who tend to have reduced access to postacute services. To address unequal care received by Black communities, a shift to community-based programs that deliver culturally-tailored programs may give an alternative to a healthcare model which reinforces health inequities. However, community-based culturally-tailored programs (CBCT) are relatively understudied but show promise to improve the delivery of services to marginalized communities. The objectives of this review are to: (i) synthesize key program characteristics and outcomes of CBCT programs that are designed to improve health outcomes in Black adults with cardiovascular disease, hypertension, diabetes, or stroke and (ii) identify which of the five categories of culturally appropriate programs from Kreuter and colleagues have been used to implement CBCT programs.Methods: This is a protocol for a systematic review that will search MEDLINE, EMBASE and CINAHL databases to identify CBCT programs for Black adults with cardiovascular disease, hypertension, diabetes, or stroke.Discussion: Health inequities have disproportionately impacted Black communities and will continue to persist if adjustments are not prioritized within healthcare to provide services, care, and programs meant to address the specific barriers to better health. Many interventions meant to improve the health outcomes of marginalized groups are created using an outsider's perspective, with little input from target communities, leading to interventions that may not address the specific barriers contributing to poor health outcomes. The inclusion of community members in the design of CBCT programs allows for a deeper understanding of the issues facing the community and provides an opportunity to incorporate cultural values that may enhance the efficacy, relevance and appropriateness of programs to the target communities. Trial registration: PROSPERO CRD42021245772

Download Full-text

Community-Based Culturally Tailored Education Programs for Black Adults with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: A Systematic Review Protocol

10.1101/2021.08.24.21262410 ◽

2021 ◽

Author(s):

Joseph Hawkins Fulton ◽

Hardeep Singh ◽

Oya Pakkal ◽

Elizabeth M Uleryk ◽

Michelle LA Nelson

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Health Outcomes ◽

Cultural Values ◽

Health Inequities ◽

Black Communities ◽

Black Adults ◽

Community Based ◽

Culturally Tailored ◽

Specific Barriers

Background: Chronic conditions and stroke disproportionately affect Black adults in communities all around the world due patterns of systemic racism, disparities in care, and lack of resources. To address unequal care received by Black communities, a shift to community-based programs that deliver culturally tailored programs to meet the needs of the communities they serve, including Black adults who tend to have reduced access to postacute services, may give an alternative to a healthcare model which reinforces health inequities. However, community-based culturally tailored programs (CBCT) are relatively understudied but show promise to improve the delivery of services to marginalized communities. The objectives of this review are to: (i) determine key program characteristics and outcomes of CBCT programs that are designed to improve health outcomes in Black adults with cardiovascular disease, hypertension, diabetes, or stroke and (ii) identify which of the five categories of culturally appropriate programs from Kreuter and colleagues have been used to implement CBCT programs. Methods: This is a protocol for a systematic review that will search MEDLINE, CINAHL, and EMBASE databases to identify community-based culturally tailored programs for Black adults with cardiovascular disease, hypertension, diabetes, or stroke. Discussion: Health inequities have disproportionately impacted Black communities and will continue to persist if adjustments are not prioritized within healthcare to provide services, care, and programs meant to address the specific barriers to better health experienced. Many interventions, meant to improve the health outcomes of marginalized groups, are created with little input from target communities leading to interventions that may not address the specific barriers contributing to poor health outcomes and are designed and implemented from an outsider's perspective. The inclusion of community members allows for a deeper understanding of the issues facing the community and provides an opportunity to incorporate cultural values to potentially increase the efficacy, tailoring the intervention to distinct communities. An alternative to current healthcare interventions must be explored to reduce the health gap experienced by Black adults.

Download Full-text

Loneliness, social isolation, cardiovascular disease and mortality: a synthesis of the literature and conceptual framework

Journal of the Royal Society of Medicine ◽

10.1177/0141076820918236 ◽

2020 ◽

Vol 113 (5) ◽

pp. 185-192 ◽

Cited By ~ 1

Author(s):

Sam Hodgson ◽

Isabella Watts ◽

Simon Fraser ◽

Paul Roderick ◽

Hajira Dambha-Miller

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Health Outcomes ◽

Conceptual Framework ◽

Social Isolation ◽

English Language ◽

Qualitative Studies ◽

Socially Isolated ◽

Poor Outcomes

To conduct a systematic review and develop a conceptual framework on the mechanisms linking loneliness, social isolation, health outcomes and mortality. Electronic databases were systematically searched (PubMed, MEDLINE, Scopus and EMBASE) from inception to October 2018 followed by manual searching to identify research on loneliness, social isolation and mortality in adults published in the English language. Articles were assessed for quality and synthesised into a conceptual framework using meta-ethnographical approaches. A total of 122 articles were included. These collated observational designs examining mediators and moderations of the association in addition to qualitative studies exploring potential mechanisms were included. A framework incorporating 18 discrete factors implicated in the association between loneliness, social isolation and mortality was developed. Factors were categorised into societal or individual, and sub-categorised into biological, behavioural and psychological. These findings emphasise the complex multidirectional relationship between loneliness, social isolation and mortality. Our conceptual framework may allow development of more holistic interventions, targeting many of the interdependent factors that contribute to poor outcomes for lonely and socially isolated people.

Download Full-text

A Systematic Review and Meta-Analysis on the Effectiveness of Community-Based Non-Pharmacological Interventions to Improve the Health Outcomes Among People with Chronic Obstructive Pulmonary Disease (COPD)

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a2201 ◽

2020 ◽

Author(s):

P. Jarhyan ◽

A. Hutchinson ◽

D. Khaw ◽

D. Prabhakaran ◽

S. Mohan

Keyword(s):

Systematic Review ◽

Chronic Obstructive Pulmonary Disease ◽

Health Outcomes ◽

Pulmonary Disease ◽

Meta Analysis ◽

Chronic Obstructive ◽

Pharmacological Interventions ◽

Community Based ◽

Obstructive Pulmonary Disease

Download Full-text

Protocol for a systematic review of health promotion interventions for African Americans delivered in US barbershops and hair salons

BMJ Open ◽

10.1136/bmjopen-2019-035940 ◽

2020 ◽

Vol 10 (4) ◽

pp. e035940

Author(s):

Kelly Palmer ◽

Patrick Rivers ◽

Forest Melton ◽

Jean McClelland ◽

Jennifer Hatcher ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Health Promotion ◽

African Americans ◽

Chronic Diseases ◽

Citation Index ◽

Health Inequities ◽

Health Promotion Interventions

IntroductionAfrican American adults are disproportionately burdened by chronic diseases, particularly at younger ages. Developing culturally appropriate interventions is paramount to closing the gap in these health inequities. The purpose of this systematic review is to critically evaluate health promotion interventions for African Americans delivered in two environments that are frequented by this population: barbershops and hair salons. Characteristics of effective interventions will be identified and evidence for the effectiveness of these interventions will be provided. Results of this review will inform future health promotion efforts for African Americans particularly focused on the leading health inequities in obesity-related chronic diseases: cardiovascular disease, cancer and type 2 diabetes.Methods and analysisSubject headings and keywords will be used to search for synonyms of ‘barbershops,’ ‘hair salons’ and ‘African Americans’ to identify all relevant articles (from inception onwards) in the following databases: Academic Search Ultimate, Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO, PubMed, Web of Science (Science Citation Index and Social Sciences Citation Index) and ProQuest Dissertations. Experimental and quasi-experimental studies for adult (>18 years) African Americans delivered in barbershops and hair salons will be included. Eligible interventions will include risk reduction/management of obesity-related chronic disease: cardiovascular disease, cancer and type 2 diabetes. Two reviewers will independently screen, select and extract data and a third will mediate disagreements. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. Quality and content of the evidence will be narratively synthesised.Ethics and disseminationSince this is a protocol for a systematic review, ethical approval is not required. Findings from the review will be widely disseminated through conference presentations, peer-reviewed publications and traditional and social media outlets.

Download Full-text

Effectiveness of community-based physical activity/exercise programs on older womenʼs physical health outcomes: a systematic review

International Journal of Evidence-Based Healthcare ◽

10.1097/01258363-201309000-00095 ◽

2013 ◽

Vol 11 (3) ◽

pp. 260

Author(s):

L E Young ◽

D J Sheets ◽

A Mallidou ◽

K Paul

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Health Outcomes ◽

Physical Health ◽

Exercise Programs ◽

Community Based ◽

Physical Health Outcomes

Download Full-text

Qualitative Process Evaluation of a Community-Based Culturally Tailored Lifestyle Intervention for Underserved South Asians

Health Promotion Practice ◽

10.1177/1524839916650165 ◽

2016 ◽

Vol 17 (6) ◽

pp. 802-813 ◽

Cited By ~ 7

Author(s):

Manasi Jayaprakash ◽

Ankita Puri-Taneja ◽

Namratha R. Kandula ◽

Himali Bharucha ◽

Santosh Kumar ◽

...

Keyword(s):

Cardiovascular Disease ◽

Disease Prevention ◽

Process Evaluation ◽

Lifestyle Intervention ◽

South Asians ◽

Cardiovascular Disease Prevention ◽

Medically Underserved ◽

Community Based ◽

Culturally Tailored ◽

Study Staff

Introduction. There are few examples of effective cardiovascular disease prevention interventions for South Asians (SAs). We describe the results of a process evaluation of the South Asian Heart Lifestyle Intervention for medically underserved SAs implemented at a community-based organization (CBO) using community-based participatory research methods and a randomized control design (n = 63). Method. Interviews were conducted with 23 intervention participants and 5 study staff using a semistructured interview guide focused on participant and staff perceptions about the intervention’s feasibility and efficacy. Data were thematically analyzed. Results. Intervention success was attributed to trusted CBO setting, culturally concordant study staff, and culturally tailored experiential activities. Participants said that these activities helped increase knowledge and behavior change. Some participants, especially men, found that self-monitoring with pedometers helped motivate increased physical activity. Participants said that the intervention could be strengthened by greater family involvement and by providing women-only exercise classes. Staff identified the need to reduce participant burden due to multicomponent intervention and agreed that the CBO needed greater financial resources to address participant barriers. Conclusion. Community-based delivery and cultural adaptation of an evidence-based lifestyle intervention were effective and essential components for reaching and retaining medically underserved SAs in a cardiovascular disease prevention intervention study.

Download Full-text

Recruitment of Black Adults into Cardiovascular Disease Trials

Journal of the American Heart Association ◽

10.1161/jaha.121.021108 ◽

2021 ◽

Author(s):

Anagha Prasanna ◽

Hailey N. Miller ◽

Yingfei Wu ◽

Anna Peeler ◽

Oluwabunmi Ogungbe ◽

...

Keyword(s):

Cardiovascular Disease ◽

Clinical Trials ◽

Trial Design ◽

National Institutes Of Health ◽

Recruitment Strategies ◽

Community Members ◽

Black Adults ◽

Community Based ◽

Trial Protocols ◽

Recruitment Target

Background Although disproportionately affected by cardiovascular disease, Black adults remain underrepresented in clinical trials. The National Institutes of Health recommends that studies define goals for recruitment of underrepresented populations. However, the extent to which cardiovascular trials incorporate evidence‐based recruitment strategies in their protocols is understudied. Methods and Results We systematically reviewed National Institutes of Health‐funded cardiovascular clinical trials registered in ClinicalTrials.gov between 2000 and 2019. Based on publicly available or requested protocols, we focused on enrollment of Black adults as well as the following recruitment strategies: community‐based, electronic medical record‐based, and provider‐based recruitment. A total of 100 clinical trials focused on cardiovascular disease were included in our analysis, of which 62% had published protocols, and 46% of trials had enrolled populations that were <25% Black. In our analysis of available trial protocols, 21% of trials defined a recruitment target for underrepresented groups; however, only one study reported achieving its enrollment goal. While 13% of trial protocols referenced community‐based recruitment strategies, 5% explicitly mentioned involving community members in the trial design process. Defining recruitment targets was associated with higher enrollment of Black participants. Conclusions Black adults are underrepresented in National Institutes of Health‐funded cardiovascular trials, and the majority of these trials did not specify a Black enrollment target, did not meet targets, and largely did not report specific plans to enroll Black adults in their studies. Future interventions should target trial design and planning phases before study initiation to address these enrollment disparities.

Download Full-text