Impact of Technology-Based Intervention for Improving Self-Management Behaviors in Black Adults with Poor Cardiovascular Health: A Randomized Control Trial

• Type of Material: Article
• Authors: Tulani Washington-Plaskett, Boston University; Muhammed Y. Idris, Morehouse School of Medicine; Mohamed Mubasher, Morehouse School of Medicine; Yi-An Ko, Emory University; Shabatun Jamila Islam, Emory University; Sandra Dunbar, Emory University; Herman Taylor, Emory University; Arshed Quyyumi, Emory University; Priscilla Pemu, Morehouse School of Medicine
• Language: English
• Date: 2021-04-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijerph18073660
• Title of Journal or Parent Work: International Journal of Environmental Research and Public Health
• Volume: 18
• Issue: 7
• Grant/Funding Information: This work was supported by the American Heart Association Strategically Focused Research Network on Disparities grant number 0000031288.
• Keywords: health disparities; Life Sciences & Biomedicine; 3rd national health; Associations; Blacks; Heart; Life’ Frequency; Disparities; Socioeconomic status; Science & Technology; Environmental Sciences & Ecology; Disease; behavioral intervention technology; Public, Environmental & Occupational Health; CVD; Physical activity; Questionnaires; Environmental Sciences; equity; Risk Factors; s Simple 7
• Research Categories: Engineering, Biomedical; Engineering, Environmental; Health Sciences, Public Health; Biology, Biostatistics

Abstract

Cardiovascular disease (CVD) is the number one killer of adults in the U.S., with marked ethnic/racial disparities in prevalence, risk factors, associated health behaviors, and death rates. In this study, we recruited and randomized Blacks with poor cardiovascular health in the Atlanta Metro area to receive an intervention comparing two approaches to engagement with a behavioral intervention technology for CVD. Generalized Linear Mixed Models results from a 6-month intervention indicate that 53% of all participants experienced a statistical improvement in Life’s Simple 7 (LS7), 54% in BMI, 61% in blood glucose, and 53% in systolic blood pressure. Females demonstrated a statistically significant improvement in BMI and diastolic blood pressure and a reduction in self-reported physical activity. We found no significant differences in changes in LS7 or their constituent parts but found strong evidence that health coaches can help improve overall LS7 in participants living in at-risk neighborhoods. In terms of clinical significance, our result indicates that improvements in LS7 correspond to a 7% lifetime reduction of incident CVD. Our findings suggest that technology-enabled self-management can be effective for managing selected CVD risk factors among Blacks.