MOCHA Moving Forward: findings and lessons learned from implementing a community-based chronic disease prevention study with middle-aged black men.

Objectives: Black men in the U.S. experience disproportionately high rates of diabetes, cardiovascular disease, and prostate cancer - conditions closely linked to chronic stressors such as racial discrimination, economic precarity, and gender role strain. In response, the Men of Color Health Awareness (MOCHA) program was developed to promote the physical, mental, social, and spiritual well-being of men of color through culturally grounded discussions on structural violence, coping, and masculinity. This paper presents findings and key implementation lessons from the MOCHA Moving Forward study, which tested two intervention models: the original MOCHA program (MO) and MOCHA+, an enhanced version incorporating culturally adapted narrative dialogue.

Design: This community-academic feasibility trial randomized 210 men aged 35-70 into MO or MOCHA+ groups. Both participated in a 10-week program focused on stress and chronic disease prevention.

Results: Among participants who completed the program, statistically significant reductions were found in self-reported stress, BMI, anxiety, and depression in the MO group. When combining MO and MOCHA+ participants, reductions in stress and BMI remained significant. However, high attrition and loss to follow-up (final sample: 38) posed challenges to feasibility and scalability.

Conclusion: Despite retention challenges, findings suggest MOCHA is a promising intervention for stress and chronic disease risk reduction among men of color. The significant outcomes observed among completers highlight the program's potential and provide critical insights for improving the feasibility of future community-based interventions. Future research should explore scalable adaptations and further refine MOCHA's culturally tailored content to better support structurally marginalized populations.