Barriers and Facilitators to Improving Cardiovascular Health in Churches with Predominantly Black Congregations.

IF 3.4 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ethnicity & Disease Pub Date : 2024-04-24 eCollection Date: 2023-12-01 DOI:10.18865/ed.DECIPHeR.96
Ana Peralta-Garcia, Jodie Laurent, Alessandra N Bazzano, Marilyn J Payne, Andrew Anderson, Flor Alvarado, Keith C Ferdinand, Jiang He, Katherine T Mills
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引用次数: 0

Abstract

Objective: Black communities bear a disproportionate burden of cardiovascular disease (CVD). Barriers and facilitators for improving cardiovascular health (CVH) in churches with predominantly black congregations were explored through a qualitative needs assessment.

Methods: Four focus groups with church members (n=21), 1 with wellness coordinators (n=5), and 1 with primary care providers (n=4) and 7 individual interviews with church leaders were completed in New Orleans and Bogalusa, Louisiana. Virtual, semistructured interviews and focus groups were held between October 2021 and April 2022. The Theorical Domains Framework (TDF) guided a framework analysis of transcribed data based on inductive and deductive coding to identify themes related to determinants of CVH.

Results: The following four domains according to the TDF were identified as the most relevant for improving CVH: knowledge, professional role, environmental context, and emotions. Within these domains, barriers expressed by church leadership and members were a lack of knowledge of CVD, provider distrust, and little time and resources for lifestyle changes; facilitators included existing church wellness programs and social support, community resources, and willingness to improve patient-provider relationships. Primary care providers recognized a lack of effective communication and busy schedules as obstacles and the need to strengthen communication through increased patient autonomy and trust. Potential strategies to improve CVH informed by the Expert Recommendation for Implementing Change compilation of implementation strategies include education and training, task shifting, dissemination of information, culturally tailored counselling, and linkage to existing resources.

Conclusions: These findings can inform the implementation of interventions for improving cardiovascular health and reducing disparities in black church communities.

在以黑人会众为主的教堂中改善心血管健康的障碍和促进因素。
目的:黑人社区的心血管疾病(CVD)负担过重。通过一项定性需求评估,探讨了在以黑人会众为主的教会中改善心血管健康(CVH)的障碍和促进因素:在路易斯安那州的新奥尔良市和博格卢萨市,与教会成员(21 人)、健康协调员(5 人)和初级保健提供者(4 人)分别进行了 4 次焦点小组讨论,并与教会领袖进行了 7 次个别访谈。在 2021 年 10 月至 2022 年 4 月期间进行了虚拟半结构式访谈和焦点小组讨论。在理论领域框架(TDF)的指导下,根据归纳和演绎编码对转录数据进行了框架分析,以确定与 CVH 决定因素相关的主题:结果:根据 TDF,以下四个领域被认为与改善 CVH 最为相关:知识、专业角色、环境背景和情感。在这些领域中,教会领导和成员所表达的障碍包括缺乏心血管疾病知识、对提供者的不信任以及没有时间和资源改变生活方式;促进因素包括现有的教会健康计划和社会支持、社区资源以及改善患者与提供者关系的意愿。初级医疗服务提供者认为,缺乏有效的沟通和繁忙的日程安排是障碍,需要通过提高患者的自主性和信任度来加强沟通。根据《专家建议实施变革》汇编的实施策略,改善 CVH 的潜在策略包括教育和培训、任务转移、信息传播、针对不同文化背景的咨询以及与现有资源的联系:这些发现可为实施干预措施提供信息,以改善心血管健康并减少黑人教会社区的不平等现象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ethnicity & Disease
Ethnicity & Disease 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.30
自引率
0.00%
发文量
43
审稿时长
6-12 weeks
期刊介绍: Ethnicity & Disease is an international journal that exclusively publishes information on the causal and associative relationships in the etiology of common illnesses through the study of ethnic patterns of disease. Topics focus on: ethnic differentials in disease rates;impact of migration on health status; social and ethnic factors related to health care access and health; and metabolic epidemiology. A major priority of the journal is to provide a forum for exchange between the United States and the developing countries of Europe, Africa, Asia, and Latin America.
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