The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors.

Autor: White MJ; Department of Pediatrics, Duke University School of Medicine, DUMC 102376, 2301 Erwin Rd, Durham, NC, 27705, USA. michelle.white@duke.edu., Holliday KM; Department of Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914, Durham, NC, 27710, USA., Hoover S; Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA., Robinson-Ezekwe N; Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA., Corbie-Smith G; Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA., Williams A; Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA., Bess K; Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA., Frerichs L; Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA.; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Roseneau Hall, CB #7400, Chapel Hill, NC, 27599-7400, USA.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2021 Nov 05; Vol. 21 (1), pp. 2018. Date of Electronic Publication: 2021 Nov 05.
DOI: 10.1186/s12889-021-12022-x
Abstrakt: Background: AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults' self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking.
Methods: We conducted semi-structured interviews with AA adults (N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12.
Results: The average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives' homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives' homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support.
Conclusions: As we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.
(© 2021. The Author(s).)
Databáze: MEDLINE
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