Tailoring Mobile Health Technology to Reduce Obesity and ImproveCardiovascular Health in Resource-Limited Neighborhood Environments: A Multi-Level, Community-Based Physical Activity Intervention

National Heart, Lung, And Blood Institute

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Linked publications & trials

Abstract

We have developed a model to enhancing recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based research, particularly research that incorporates mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African-American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions, and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB) which influenced the studys design, implementation, and dissemination. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African-American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities. Data on women in the Washington, DC Health and Needs Assessment provided initial insights into mHealth user engagement for the future PA intervention cohort. Among women in the assessment (99% African American mean age=59 (12) years), 90% had a body mass index (BMI) categorized as overweight or obese, with 30% having Class-I obesity, 19% having Class-II obesity, and 17% having Class-III obesity. Across weight classes, PA decreased (p<0.05) and self-reported sedentary time increased (p<0.05). Although diastolic blood pressure and fasting blood glucose significantly increased across weight categories among women, blood pressure, cholesterol, and glucose were relatively well-controlled with mean values consistent with ideal or intermediate levels of the American Heart Associations CV health cut-points. PA-monitoring system compliance remained above 60% for the 30-day study period among women participating in the study, with similar compliance among women with obesity over the study period. Therefore, deployment of mHealth technology with CBPR strategies can help target PA for improving cardiovascular health among African American women in resource-limited communities.