scholarly journals Improvements in Diet and Physical Activity-Related Psychosocial Factors among African Americans using an mHealth Lifestyle Intervention to Promote Cardiovascular Health: the FAITH! Pilot Study (Preprint)

10.2196/28024 ◽  
2021 ◽  
Author(s):  
Jissy Cyriac ◽  
Sarah Jenkins ◽  
Christi A. Patten ◽  
Sharonne N. Hayes ◽  
Clarence Jones ◽  
...  
2021 ◽  
Author(s):  
Jissy Cyriac ◽  
Sarah Jenkins ◽  
Christi A Patten ◽  
Sharonne N Hayes ◽  
Clarence Jones ◽  
...  

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]


2020 ◽  
Vol 4 (s1) ◽  
pp. 53-53
Author(s):  
LaPrincess Brewer ◽  
Ashok Kumbamu ◽  
Christina Smith ◽  
Sarah Jenkins ◽  
Clarence Jones ◽  
...  

OBJECTIVES/GOALS: To evaluate the FAITH! (Fostering African-American Improvement in Total Health) App mHealth lifestyle intervention by using post-intervention feedback obtained from participants in our intervention pilot study. METHODS/STUDY POPULATION: We used qualitative methods (focus groups) to elicit post-intervention feedback. Participants who completed the pilot study were recruited to one of two focus groups. Semi-structured focus groups were conducted to explore participants’ views on the app functionality, utility and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded, transcribed verbatim and qualitative data were analyzed by systematic text condensation thematic analysis. RESULTS/ANTICIPATED RESULTS: Nine individuals participated (N = 4 and N = 5) in each of the two focus groups. Their mean age was 47.9 years (SD 12.1), 67% were women, and all had at least an education level of some college. Six overarching themes emerged from the data: (1) overall impression, (2) content usefulness (3) formatting, (4) implementation, (5) impact and (6) suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules and social networking. Among the suggestions for improvement were streamlining of app self-monitoring features, personalization based on individual’s cardiovascular risk and attentiveness to nuanced cultural perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This formative evaluation found the FAITH! App mHealth lifestyle intervention had high reported satisfaction and impact on the health-promoting behaviors of African-Americans, thereby improving their overall cardiovascular health. The findings provide further support for the acceptability of mHealth interventions among African-Americans. CONFLICT OF INTEREST DESCRIPTION: None.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Mario Sims ◽  
LáShauntá Glover ◽  
Arnita Norwood ◽  
Christina Jordan ◽  
Yuan-I Min ◽  
...  

Introduction: Compared to other racial and ethnic groups, African Americans experience greater negative psychosocial factors (depression, stress), which are related to increased risk of cardiovascular disease (CVD). Little research has examined the association of positive psychosocial factors (optimism) with cardiovascular health in this population. Using the Jackson Heart Study (JHS) data, we examined the association of optimism with the American Heart Association Life’s Simple 7 TM (LS7), a measure of seven metrics that assesses a person’s cardiovascular health. Hypothesis: Higher levels of optimism are positively associated with individual LS7 metrics, and positively associated with the total LS7 score. Methods: We evaluated cross-sectional associations of optimism with each LS7 metric [cigarette smoking, physical activity, diet, body mass index (BMI), blood pressure, cholesterol, glucose] and with a composite LS7 score among 4,761 participants, 21-95 years old (women=3,070; men=1,691) enrolled in the JHS, a single-site, community-based cohort of African Americans residing in Jackson, MS. Optimism was measured in tertiles (low, moderate, high) to examine threshold effects. Each LS7 metric was classified as poor, intermediate, and ideal. LS7 metrics were also summed to create a total continuous score (0-13) categorized in tertiles (low, moderate, high). Multinomial logistic regression estimated the odds ratios (OR, 95% confidence interval-CI) of intermediate (vs. poor) and ideal (vs. poor) LS7 metric by levels of optimism. Multinomial regression also estimated the odds of moderate (vs. low) or high (vs. low) total LS7 score by optimism. Models adjusted for demographics, SES, and depressive symptoms. Results: Descriptive findings showed that participants who reported high optimism had ideal physical activity, nutrition, smoking, blood pressure, glucose and high total LS7 score (all p<0.01). After adjustment for age, sex, education, income, marital status, and insurance status, participants who reported high (vs. low) optimism had a 39% increased odds of having ideal (vs. poor) physical activity (OR 1.39; 95% CI 1.10-1.76) and a 33% increased odds of having ideal (vs. poor) smoking (OR 1.33; 95% CI 1.02-1.73). Participants who reported high (vs. low) optimism had a 34% greater odds of having a high (vs. low) total LS7 score (OR 1.34 95% CI 1.03-1.74) after full adjustment. Conclusion: Optimism is associated with ideal physical activity and ideal smoking, which is important for promoting cardiovascular health and reducing the risk of CVD among African Americans in this sample.


2019 ◽  
Vol 34 (8) ◽  
pp. 1376-1378 ◽  
Author(s):  
LaPrincess C. Brewer ◽  
Sharonne N. Hayes ◽  
Sarah M. Jenkins ◽  
Kandace A. Lackore ◽  
Carmen Radecki Breitkopf ◽  
...  

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S518-S518
Author(s):  
C R Lamers ◽  
N M de Roos ◽  
H H Heerink ◽  
L A van de Worp - Kalter ◽  
B J M Witteman

Abstract Background Diet and physical activity might help to improve quality of life and maintain remission in patients with inflammatory bowel disease (IBD). In other conditions, interventions in which diet and physical activity are combined seem to be more effective than separate interventions. Therefore, we assessed the effect of a combined lifestyle intervention on the impact of disease on daily life, clinical disease activity, fatigue and quality of life in patients with Crohn’s disease (CD) or ulcerative colitis (UC). Methods A single arm intervention study was performed in IBD patients in remission or with mildly active disease. Participants received personal advice to improve their diet and level of physical activity by a dietician and a physiotherapist in one face-to-face and one telephone consult. These advices were supported by guidelines based on the Dutch dietary and physical activity guidelines, a recipe app and a booklet with physical activity exercises. IBD disability index (IBD-DI) to assess impact of disease on daily life, clinical disease activity questionnaires (P-HBI or P-SCCAI), IBD fatigue (IBD-F) patient self-assessment scale and IBD quality of life questionnaire (IBDQ) were completed. The Eetscore Food Frequency Questionnaire (Eetscore FFQ) and Short Questionnaire to Assess Health-enhancing physical activity (SQUASH) were used to assess diet and physical activity. Changes from baseline to 5 weeks after start were investigated by paired samples t-tests or Wilcoxon signed rank tests. Results We included 29 participants. At time of this preliminary analysis, 25 participants completed baseline and 5-week assessments (11 males, 11 CD, median age 36 years [IQR 29–53], median BMI 25 kg/m2 [IQR 24–28]). After 5 weeks, diet quality had significantly improved (p&lt;0.001), but level of physical activity had not (p=0.509). Impact of disease on daily life (IBD-DI) decreased with 2.5 points (95%CI -5.5-0.4; p=0.09). Disease activity did not change significantly. There was a significant decrease in fatigue (median IBD-F 20 [IQR 8–29] to 15 [IQR 3–24; p=0.03]) and a significant increase in quality of life (median IBDQ 194 [IQR 179–206] to 196 [IQR 186–209; p=0.03]). Conclusion These preliminary results suggest that a combined lifestyle intervention is effective to reduce fatigue and to increase quality of life in patients with IBD, at least in the short term. Impact of disease on daily life and clinical disease activity did not improve significantly. Participants reported their level of physical activity to be restricted due to COVID-19 measures, which could explain the lack of effect on this outcome. This study is still ongoing and we expect follow-up data up till 1 year after start.


Author(s):  
Marica Franzago ◽  
Marta Di Nicola ◽  
Federica Fraticelli ◽  
Michele Marchioni ◽  
Liborio Stuppia ◽  
...  

Abstract Aims Nutritional and lifestyle interventions can contribute to prevent and treat obesity and its complications; however, genetic background may influence the success of a therapy. The aim of this pilot study is to evaluate the effects of the interaction between nutrigenetic variants and nutritional intervention, as well as the changes in clinical parameters and the adherence to Mediterranean diet (MedDiet) and to physical activity, of 18 overweight or obese subjects affected by T2D or dysglycemia included in a nutritional program. Methods The subjects’ clinical parameters as well as their PREDIMED score and physical activity levels were recorded and compared at baseline, at 6 months and at the end of the intervention. Rs9939609 in FTO, rs17782313 near MC4R, rs326 in LPL, rs16147 in NPY, rs2943641 near IRS-1 were genotyped. Results The subjects carrying the A allele in FTO lost less weight (p = 0.022) and had a lower BMI decrease from baseline to 12 months (p-interaction = 0.047) than TT carriers. In addition, there was a significant PREDIMED score modification over time, according to genotypes for FTO rs9939609 (p = 0.025) and NPY rs16147 (p = 0.039), respectively. Conclusions These preliminary findings show a significant interaction between genetic variants and the PREDIMED score, suggesting that individuals carrying the FTO variant may lose less weight than non-carriers through diet/lifestyle intervention.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Holly C Gooding ◽  
Carly Milliren ◽  
Christina M Shay ◽  
Tracy K Richmond ◽  
Alison E Field ◽  
...  

Introduction: Adults who reach middle age with optimal levels of three physiologic factors – blood pressure, cholesterol, and blood glucose – have lower rates of CVD mortality compared to those with one or more of these risk factors in the non-optimal range. The American Heart Association has identified four healthy lifestyle components – BMI, smoking, diet, and physical activity – important for preserving optimal cardiovascular health as people age. However, which lifestyle components in adolescence are most strongly associated with physiologic markers of cardiovascular health in adulthood is unclear. The purpose of this study was to quantify associations between lifestyle components measured in adolescence and optimal physiologic cardiovascular health in young adulthood. Methods: Analyses included 9,697 young adults, age 24-32 years in 2007-2008, who participated in Wave IV of the National Longitudinal Study of Adolescent Health. We defined optimal physiologic cardiovascular heath as untreated blood pressure <120/80 mmHg, untreated fasting blood glucose <100 mg/dL and hemoglobin A1C < 5.7%, untreated total cholesterol in the bottom 7 (women) or 6 (men) deciles for the study population, and absence of diabetes or CVD as measured at Wave IV. We used logistic regression models to estimate the odds of having optimal physiologic cardiovascular health in young adulthood according to BMI category, smoking status, and physical activity patterns measured during Waves I and II when participants were ages 11-20 years. Dietary data were not available. Models were adjusted for age, sex, race, educational attainment, and income in young adulthood. Results: Few young adults (16%, 1,592 of 9,697) had optimal physiologic cardiovascular health. Young adults who had been normal-weighted in adolescence were more likely to have optimal physiologic cardiovascular health (18.4%, 1,382 of 7,206) compared to those who had been overweight (9.4%, 142 of 1,429) or obese (6.9%, 68 of 1,062). In models adjusted for young adult sociodemographic factors, participants who had been overweight or obese as adolescents were less than half as likely as those who had been normal-weighted to have optimal physiologic cardiovascular health in young adulthood (overweight odds ratio (OR) 0.43, 95% confidence interval (CI) 0.35-0.61; obese OR 0.40, 95% CI 0.28-0.57). Adolescent tobacco smoking and physical activity were not associated with young adult cardiovascular health. Conclusions: Maintaining a healthy weight in adolescence may be the most important lifestyle factor for reaching young adulthood with optimal physiologic cardiovascular health. Overweight and obese adolescents should be encouraged to achieve a healthy weight through adherence to diet and physical activity goals.


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