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April 15, 2019

Culturally relevant health app shows positive impact

By Advancing the Science contributor

LaPrincess Brewer, M.D., explaining heart health to a community member, using a hands-on model.

By Jay Furst

Mobile apps are popular sources of fast and easily digested consumer health information. But can they actually help in measurable ways to make you more healthy?

According to a pilot study by Mayo Clinic researchers, they can if the content is presented in a culturally relevant, targeted and engaging way — and in this case, it helps that the mobile health, or mHealth, intervention was developed in collaboration with the people who used it, within African American faith communities.

Dr. Brewer receives a demonstration of the app from David Derby, senior innovation project manager, Mayo Clinic Kern Center for the Science of Health Care Delivery.

Members of five African American church communities in Rochester, Minn., and the Minneapolis-St. Paul metro area, helped develop the app. The researchers then enrolled 50 African American adults in a 10-week study that included podcasts and multimedia educational modules on the app. Though the study was small in size, the intervention resulted in "several objectively measured positive outcomes for cardiovascular health," according to the study, which was published online in March in the Journal of General Internal Medicine.

"This project was unique in that we used an unconventional app to develop a community-based health intervention — and we developed our intervention in partnership with the community," says LaPrincess Brewer, M.D., a cardiologist in Mayo Clinic's Department of Cardiovascular Medicine.

"The power and innovation of mobile health" was evident in the community engagement and outcome from this research prototype, says Dr. Brewer, the study's first author. Participants "found it to be fun and engaging," as well as contributing in measurable ways to their wellness.

Putting FAITH into action

The mHealth study was part of an innovative Mayo Clinic program called Fostering African-American Improvement in Total Health (FAITH), a participatory research effort aimed at preventing heart disease in underserved communities.

According to the American Heart Association, African Americans are significantly less likely than whites to meet five or more of seven factors that affect cardiovascular health. Those factors, which the association calls Life's Simple 7 — diet, physical activity, smoking, body mass index, blood pressure, total cholesterol and fasting glucose — were used to assess the participants’ progress.

The study was conducted from October to December 2016, with follow-up assessments 28 weeks later. The study showed improvement in the biological measures, including blood pressure and total cholesterol, with significant improvement in the composite average for all seven factors.

"Our intervention, although a research prototype, offers an innovative medium to engage African American patients beyond office-based encounters through mobile technology with an overarching goal of diminishing cardiovascular disease risk and mortality," the report says.

The study is believed to be the first to use a mobile health app as an intervention for improved  cardiovascular health among African Americans. A randomized controlled trial is the next step for assessing the model's effectiveness, and Dr. Brewer says the app is being refined to make it "more user-friendly and more individualized to improve health behaviors."

The app hasn't been made available to the public, though Dr. Brewer says, "We are hoping that the mHealth lifestyle intervention will be available from the Mayo Clinic website for download, and for faith-based organizations national and internationally to use as a part of their health promotion programming."

App reflects community input

The research is part of Mayo Clinic's commitment to community-based participatory research that addresses health disparities. Coordinated by the Office of Health Disparities Research, similar collaborations with faith-based communities have been undertaken in Arizona and Florida.

One of the study participants, Clarence Jones, of Minneapolis, says, "The one emotion I have observed most from the participant groups is excitement — the excitement to see a product emerge from their input, and one that reflects their community and its values."

Jones says the experience also was an opportunity for members to interact with researchers in a nontraditional way, where "their voice is being heard and considered before decisions are made. While this may seem like a simple thing, it is often not experienced by community members working with researchers."

Another participant, Pamela Carter, of Roseville, Minn., says the 10-week intervention "made me more conscious of my daily activities. The constant reminders make this information a little more imprinted in your mind.”

Dr. Brewer's work is supported by a grant from the National Institutes of Health and the Mayo Clinic Women's Health Clinic. The study also was supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Center for Clinical and Translational Science, Department of Cardiovascular Medicine and Office of Health Disparities Research.

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Tags: artificial intelligence, cardiology, Center for Clinical and Translational Science, Center for the Science of Health Care Delivery, diversity, Findings, health disparities, Innovations, LaPrincess Brewer, News, Office of Health Disparities Research, women's health

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