Developing and Testing a New

Model to Reduce Risk for

Heart Disease and Stroke

PI: Ruth Lindquist, PhD, RN, FAAN, Professor

University of Minnesota ,School of Nursing

Partner: National USA Foundation, Inc. (NUFI)

Rev./Dr. LB West, Mount Airy Baptist Church, Washington, D.C.

A. Significance

AA men live 4 year less than their Caucasian counterparts

CVD in large part a behavioral disease

Men are viewed within the context of their community

B. Innovation

Novel Peer Group Support

Mechanism

• Okinawan “Moai”

• Increasing level of accountability, encouragement, and salutary, enduring health behavior change

Use of Technological tools

• Smart phone

• Physical activity tracker

• Text messaging

Audio Recording

• Graining insight into change processes and support for behavior change among peer groups

B. Innovation

↑Awareness

Education

Personal risk

(screening)

↑Activation

Ready to

change

Demonstrated

commitment

(run-in)

↑Awareness

Effort to

change

Outcomes

↑Knowledge

Improved health

behaviors

Improved health

Reduced CVD risk

+ Role modeling

+ Culture impact

↓Community

CVD risk

Intervention

Goal

setting

Education Inspiration Ongoing

Feedback

“tracking”

Peer

support

advice

Community

CVD risk

Conceptual Model

C1. Preliminary work

• “SOAR”: church initiated health program

• 10-week behavioral weight loss program

• 16-week text messaging and small peer group weight

management program

• Qualitative Interviews of weight loss program

C2. Justification and Feasibility

• Life’s Simple 7

• Community partners

C. Approach

Subjects and Setting

C.3. Research Design

Phase I (Education)

Inclusion:

Men, 40-70 year old, who identify as AA, able to read and write in English and provide informed consent and who are members.

Setting:

New Salem Missionary Baptist Church ( n ≈ 700)

Mount Airy Baptistic Church (n ≈ 300)

Phase II and III (Screening & BP) “Run-In”

Added inclusion:

Having a health activation score in the upper 50th percentile

Exclusion:

Active smoker, illicit drug users, and men with alcoholism or psychiatric illness

Phase IV and V (Support)

Inclusion:

Having one or more risks for CVD according to AHA guideline Life’s Simple 7; compliance shown in attending weekly BP checks; health activation reflecting readiness to or contemplation of health behavior change; willingness to commit time to 6-month program and be randomized.

Subjects and Setting – Performance sites

C.3. Research Design

Performance sites

C.3. Research Design

New Salem Missionary

Baptist Church

Minneapolis, MN

Mount Airy Baptist Church

Washington D.C

Pastor: Jerry McAfee Pastor: Rev. L. B. West, D.R.S.

C.4. Measures

I. Primary Outcome Measures

(Life’s Simple 7)

Total Cholesterol

Blood Pressure

Blood Glucose

Physical Activity

Health diet score

Obesity Smoking

C.4. Measures

II. Psychosocial and Behavioral Measures

Stage of Change/

Readiness to Change

Dietary Knowledge

Healthy Eating

Change Strategies

Framingham Coronary

Heart Disease

Risk Score

Self-reported current

smoking

Self-rated Health

BRFSS 4-item activity

scale

General Food

Knowledge Questionnai

re

Physical Activity

My Fitness Pal

III. Biometric Measures

Blood pressures

Bloods

IV. Anthropologic

Measures

Weight Height BMI

C.5. Intervention Model Phases

Phase I

Education

Video Presentation

Phase II

Health Screening

30-40 men

Health activation will be assessed

Consent and Measures

Phase III

Blood Pressure Run-In

3-week Blood pressure check

Recruit to enroll in the 6-month program

Phase IV

6-month small group support, education, and behavioral change

Weekly -> Bi-weekly -> Monthly

Phase V

Follow-up

2 month after the end of Phase IV

C.5. Small groups

Video

presentation

Life’s Simple 7

Trained

Facilitator

Invisible

RA

Timeline of Study Activity

September October –

November

December - May June July - August

Planning &

Development

Follow-up Grant

Development

Phase I

Congregational

Education &

Measures

Follow-up

Congregational

Measures

Phase II

Biometric

Screening

Post Biometric

Screening

Phase III BP

“Run-In”

Baseline

Measures

Phase IV Behavioral Change

Intervention & RCT

Post Intervention

Measure

Phase V

Follow-Up

Study Analyses,

Model Revision

Thank you!