Rationale, design, and participant characteristics of the FAITH! Heart Health+ study: An exploration of the influence of the social determinants of health, stress, and structural racism on African American cardiovascular health.

BACKGROUND: African Americans (AAs) face cardiovascular health (CVH) disparities linked to systemic racism. The 2020 police killing of Mr. George Floyd in Minneapolis, Minnesota, alongside the COVID-19 pandemic, exacerbated adverse psychosocial factors affecting CVH outcomes among AAs. This manuscript describes the study protocol and participant characteristics in an ancillary study exploring the relationship between biopsychosocial factors and CVH among AAs. METHODS: Using a community-based participatory approach, a mixed-methods ancillary study of 58 AA participants from an overarching randomized control trial (RCT) was conducted. Baseline RCT health assessments (November 2020) provided sociodemographic, medical, and clinical data. Subsequent health assessments (February-December 2022) measured sleep quality, psychosocial factors (e.g., high-effort coping), biomarkers (e.g., cortisol), and cardiovascular diagnostics (e.g., cardio-ankle vascular index). CVH was assessed using the American Heart Association Life's Simple 7 (LS7) (range 0 to 14, poor to ideal) and Life's Essential 8 (LE8) scores (range 0 to 100, low to high). Correlations between these scores will be examined. Focus group discussions via videoconferencing (March to April 2022) assessed psychosocial and structural barriers, along with the impact of COVID-19 and George Floyd's killing on daily life. RESULTS: Participants were predominantly female (67%), with a mean age of 54.6 [11.9] years, high cardiometabolic risk (93% had overweight/obesity and 70% hypertension), and moderate LE8 scores (mean 57.4, SD 11.5). CONCLUSION: This study will enhance understanding of the associations between biopsychosocial factors and CVH among AAs in Minnesota. Findings may inform risk estimation, patient care, and healthcare policies to address CVD disparities in marginalized populations.

Challenges and Opportunities of Providing Pediatric Funeral Services: A National Survey of Funeral Professionals.

BACKGROUND: Funeral professionals offer a unique opportunity to support, educate, and advocate for grieving families after the death of a child. From the initial point of contact to the burial, funeral professionals shape the final moments and memories of a family and a community. And yet, little is known about the needs of funeral professionals to provide high quality services when a child dies. OBJECTIVES: To conduct a needs assessment among funeral professionals in conducting funeral services for children. METHODS: Active National Funeral Directors Association members were surveyed on their experience and needs in providing pediatric funeral services. The survey contained 41 questions about experience, skills, and knowledge in providing pediatric funerals. The survey included multiple choice, yes/no, and open-ended questions. Descriptive statistics were generated from the survey items and comments/open-ended questions were coded and assessed for themes. RESULTS: More than 200 responses were received. The respondents conducted 43 pediatric funeral services in a 5-year period (approx. 8 services/year). The top 5 self-identified training needs included grieving parents, grieving siblings, memorials, comforting the community, and outreach. Themes from the open-ended questions were (a) maintaining professionalism, (b) managing emotions and experiences, (c) assessing family dynamics, (d) managing professional skills, and (e) building collaborative networks. CONCLUSIONS: Specific training needs were identified that will inform the development of targeted training for funeral professionals to improve their skills and knowledge of pediatric funeral services.