Browsing by Subject "Community-Based Participatory Research"
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Item Lessons Learned from the Design and Implementation of a Health Promotion Intervention for African American Women(2022-08) Dodgen, Leilani, A.; Spence-Almaguer, EmilyThe purpose of this dissertation is to explore how intervention design can be enhanced to influence the health of African American women through examining the processes and methods related to health behavior theory, cultural adaptation, and participatory approaches. Data from African American women who participated in the Better Me Within (BMW)Trial, as well as, formative data from focus groups with African American women were used to investigate these intervention planning approaches through the following aims: Aim 1 addressed the question how do theoretical constructs of behavior change help to explain health outcomes in the BMW trial? This was quantitatively explored by examining theoretical constructs with outcomes of weight, diet and physical activity. Aim 2 explored the perspectives of African American women through qualitative analysis of focus groups for cultural and contextual elements that may influence the approach to intervention design, increase knowledge about cultural adaptations, and contribute methods to enhance weight management. Aim 3 critically examined how the community-based participatory research (CBPR) approach with African American faith communities in the BMW Trial aligned with the CBPR conceptual model through a case study. Understanding how processes, operations, and decisions in intervention design contribute to health improvements is imperative for ensuring programs are relevant and effective in specific populations. One size does not fit all. The current state of health inequities and chronic conditions in African American women require thoughtful intervention strategies that center community knowledge, culture, and context. This dissertation seeks to arrive at intervention strategies that are relevant to African American women, and influence how public health professionals approach intervention development for meaningful, community-identified health improvements.Item THE GOODNEWS (GENES, NUTRITION, EXERCISE, WELLNESS AND SPIRITUALITY) TRIAL: FINDINGS FROM A HEALTH PROMOTION INVENTION ON THE BELIEFS OF AFRICAN AMERICAN ADULTS IN SOUTH DALLAS ON CARDIOVASCULAR DISEASE RISK FACTORS(2013-04-12) Ola, OlatundePurpose: Significant disparities persist in the prevalence, morbidity, and mortality associated with cardiovascular diseases (CVD) and major risk factors based on race and ethnicity; the NIH supports risk factor reduction as the most desirable strategy for reducing CVD morbidity and mortality in high-risk populations. Methods: The GoodNEWS Program is a community-based participatory research (CBPR) project among twenty - eight (28) African-American congregations in Dallas, Texas. The partnership has existed for more than ten (10) years with significant community input and engagement. We recently completed a randomized National Institutes of Health (NIH) study, testing the effectiveness of our CBPR partnership on changing health beliefs, eating behavior and increasing physical activity. Results: Baseline data from October 2008 (N=392) indicate that most GoodNEWS participants are overweight (18.7%) or obese (67.3%), and almost one-half (48.3%) have metabolic syndrome. Participants have substantially higher levels of diagnosed disease compared to CDC national averages for African-American adults: heart disease (9.3% vs. 6.1%), diabetes (15.3% vs. 11.8%), high cholesterol (36.3% vs. 14.5%), and high blood pressure (47.5% vs. 31.6%). At the 18-month post-intervention follow-up in April 2010, the intervention group had significant reductions in food energy intake (kcal) (p=.01). However, beliefs about the effects of diet on health outcomes only changed in the control group and not the intervention group. Control participants increased their belief that diet is related to high blood pressure (p=.04), that cholesterol is related to weight gain (p=.017), and that salt intake contributes to high blood pressure (p= .015). Conclusions: The GoodNEWS program demonstrates that a strong community partnership can contribute to reducing CVD risk through food energy intake among African-American adults in the community-congregation setting. However, although intervention participants reduced caloric intake, this was not accompanied by changes in the beliefs of intervention program participants regarding diet and disease outcomes. Indeed, only the control group participants improved their understanding of this relationship. The study did not control for individual-level factors which may have mediated the relationship between the treatment variable and individuals' health beliefs.