Addressing non-medical health-related social needs through a community-based lifestyle intervention during the COVID-19 pandemic: The Black Impact program.

Autor: Joseph JJ; The Ohio State University College of Medicine, Columbus, Ohio, United States of America., Gray DM 2nd; The Ohio State University College of Medicine, Columbus, Ohio, United States of America.; The Ohio State University James Center for Cancer Health Equity, Columbus, Ohio, United States of America., Williams A; The Ohio State University College of Medicine, Columbus, Ohio, United States of America., Zhao S; The Ohio State University College of Medicine, Columbus, Ohio, United States of America., McKoy A; The Ohio State University College of Medicine, Columbus, Ohio, United States of America.; The Ohio State University James Center for Cancer Health Equity, Columbus, Ohio, United States of America., Odei JB; The Ohio State University College of Public Health, Columbus, Ohio, United States of America., Brock G; The Ohio State University College of Medicine, Columbus, Ohio, United States of America., Lavender D; The African American Male Wellness Agency, National Center for Urban Solutions, Columbus, Ohio, United States of America., Walker DM; The Ohio State University College of Medicine, Columbus, Ohio, United States of America., Nawaz S; The Ohio State University College of Public Health, Columbus, Ohio, United States of America., Baker C; Healthcare Collaborative of Greater Columbus, Columbus, Ohio, United States of America., Hoseus J; Healthcare Collaborative of Greater Columbus, Columbus, Ohio, United States of America., Price T; Healthcare Collaborative of Greater Columbus, Columbus, Ohio, United States of America., Gregory J; The African American Male Wellness Agency, National Center for Urban Solutions, Columbus, Ohio, United States of America., Nolan TS; The Ohio State University James Center for Cancer Health Equity, Columbus, Ohio, United States of America.; The Ohio State University College of Nursing, Columbus, Ohio, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Mar 09; Vol. 18 (3), pp. e0282103. Date of Electronic Publication: 2023 Mar 09 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0282103
Abstrakt: Background: Non-medical health-related social needs (social needs) are major contributors to worse health outcomes and may have an adverse impact on cardiovascular risk factors and cardiovascular disease. The present study evaluated the effect of a closed-loop community-based pathway in reducing social needs among Black men in a lifestyle change program.
Methods: Black men (n = 70) from a large Midwestern city participated in Black Impact, a 24-week community-based team lifestyle change single-arm pilot trial adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Participants were screened using the Centers for Medicare and Medicaid Services (CMS) Accountable Health Communities Health-Related Social Needs Screening Tool. Participants with affirmative responses were referred to a community hub pathway to address social needs. The primary outcome for this analysis is change in social needs based on the CMS social needs survey at 12 and 24 weeks using mixed effect logistic regressions with random intercepts for each participant. Change in a LS7 score (range 0-14) from baseline to 12 and 24 weeks was evaluated using a linear mixed-effects model stratified by baseline social needs.
Results: Among 70 participants, the mean age of participants was 52 ±10.5 years. The men were sociodemographically diverse, with annual income ranging from <$20,000 (6%) to ≥$75,000 (23%). Forty-three percent had a college degree or higher level of education, 73% had private insurance, and 84% were employed. At baseline 57% of participants had at least one social need. Over 12 and 24 weeks, this was reduced to 37% (OR 0.33, 95%CI: 0.13, 0.85) and 44% (OR 0.50, 95%CI: 0.21, 1.16), respectively. There was no association of baseline social needs status with baseline LS7 score, and LS7 score improved over 12 and 24 weeks among men with and without social needs, with no evidence of a differential effect.
Conclusions: The Black Impact lifestyle change single-arm pilot program showed that a referral to a closed-loop community-based hub reduced social needs in Black men. We found no association of social needs with baseline or change in LS7 scores. Further evaluation of community-based strategies to advance the attainment of LS7 and address social needs among Black men in larger trials is warranted.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Joseph et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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