The Church as a Bridge to Deliver Health Resources via Telehealth to Alleviate Obesity and Chronic Disease Disparities in Rural African Americans of Mississippi

University Of Southern Mississippi, Hattiesburg MS

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Abstract

? DESCRIPTION (provided by applicant): Obesity incidence/prevalence continues to plague the Southern U.S. and is worst in Mississippi (MS). Of great concern to MS is that rural and African American populations (both predominant in the state) are at greater risk for obesity/-related comorbidities. Evidence-based and theory-driven strategies are needed to address these health disparities and are limited for younger populations and men. Community-based participatory research and church-based intervention models have shown promise for reaching underserved populations. Evidence is limited with regard to church-based obesity management programs that provide resources absent in the community. Additionally, telehealth has potential to address gaps in health intervention delivery. Thus, the overall aims of this project are to: 1. assess the feasibility of a theory-driven (Socio-ecological [SEM], Transtheoretical [TTM] and Health Belief [HBM] Models), church-based intervention with a telehealth component to reduce obesity and related chronic disease risk in rural, African Americans using the RE-AIM framework, and 2. determine the reach of a mobile application for patient engagement with interventionists and health care providers (primary care provider and registered dietitian [RD]). From a rural community, African American, adult (between ages 21 and 50 with a BMI>25) men (n=25) and women (n=25) with at least one elementary-aged child in the household will be recruited from church leaders/members and local health care agencies. Twelve group education sessions (paired with men and women breakout motivational interviewing sessions, delivered by an RD and facilitated by telehealth) for adults and children will be delivered over the course of six months and health ministry supporting events over the course of 12 months. A mobile application will facilitate participant monitoring/retention, data collection, and communication with health care providers. The intervention is guided by the SEM to impact intrapersonal (i.e., motivational interviewing; self-monitoring), interpersonal (i.e., family programs for men, women and children; primary care provider support), organization (i.e., pastoral leadership; health ministry development) and environment/policy (i.e., community coalition; inform health program policy) levels of change. The HBM is used to provide cultural tailoring to redirect thought of body ideals and weight loss to health and weight loss with a goal to increase the likelihood of behavior change (based on TTM). The feasibility assessment will examine these five areas: 1. Reach (i.e., number of participants enrolled, participation rate), 2. Efficacy (i.e., weight outcomes), 3. Adoption (i.e., church acceptance of and readiness for intervention), 4. Implementation (i.e., number of health ministry events), and 5. Maintenance (i.e., post-intervention sustainability). Expected weight loss goals will be 10% of weight loss at post-intervention. Focus groups will also be conducted to capture qualitative data. Baseline characteristics of participants will be examined using ANOVA models. Means testing will be conducted to assess outcome variables (anthropometric, diet, physical activity and psychosocial variables) using paired t test analyses. PUBLIC HEALTH: The proposed Church Bridge intervention project will provide an innovative, evidence-based and technology supported, health intervention model for Southern, African American, and rural populations who continue to be disparately burdened by obesity and associated co-morbidities (i.e., hypertension, diabetes, cardiovascular disease). By targeting young adults (21-50 years of age) with families, the project will contribute to the long- term reduction of preventable chronic disease and related health care costs for the public.