Impact of Technology-Based Intervention for Improving Self-Management Behaviors in Black Adults with Poor Cardiovascular Health: A Randomized Control Trial.

Cardiovascular disease (CVD) is the number one killer of adults in the U.S., with marked ethnic/racial disparities in prevalence, risk factors, associated health behaviors, and death rates. In this study, we recruited and randomized Blacks with poor cardiovascular health in the Atlanta Metro area to receive an intervention comparing two approaches to engagement with a behavioral intervention technology for CVD. Generalized Linear Mixed Models results from a 6-month intervention indicate that 53% of all participants experienced a statistical improvement in Life's Simple 7 (LS7), 54% in BMI, 61% in blood glucose, and 53% in systolic blood pressure. Females demonstrated a statistically significant improvement in BMI and diastolic blood pressure and a reduction in self-reported physical activity. We found no significant differences in changes in LS7 or their constituent parts but found strong evidence that health coaches can help improve overall LS7 in participants living in at-risk neighborhoods. In terms of clinical significance, our result indicates that improvements in LS7 correspond to a 7% lifetime reduction of incident CVD. Our findings suggest that technology-enabled self-management can be effective for managing selected CVD risk factors among Blacks.

Black Resilience - Broadening the Narrative and the Science on Cardiovascular Health and Disease Disparities.

The health of African Americans has been largely described in terms of deficits, disease and death. Little attention has been historically given to the fact that African Americans as a population show the sustained ability to survive an evolving array of social, economic and environmental adversities that date back to more than a century before the founding of the United States. While these inequities have indeed taken (and continue to take) a devastating toll, there is also wide heterogeneity in outcomes, suggesting the existence of substantial individual and collective resilience among African Americans. This Perspective aims to stimulate discussion and research that explores resilience in a population in which "overcoming" and "bouncing back" from adversities (ranging from minor incidents to legally ordained, chronic and horrific oppression) has been a requirement for survival. Rigorous scientific exploration of Black resilience may yield important insights into the phenomenon of human resilience that transcend race.