ABSTRACT
OBJECTIVE: Churches in socioeconomically disadvantaged neighborhoods serve as safe havens in many Black communities. Churches provide faith and charitable services but often have limited resources to address the mental health needs of their communities. This article reports on a collaborative effort, driven by members of a Black church, to understand mental health needs, coping strategies, and resilience factors in a community of socioeconomically disadvantaged Black Americans. METHODS: A community-based participatory research effort was established among a church, a community mental health organization, clinicians, and researchers to interview and survey individuals residing near the church. RESULTS: The sample consisted of 59 adults, most of whom were ages 46-65 years, men (N=34, 58%), and unemployed (N=46, 78%). Mean scores on the Patient Health Questionnaire-9 (9.2±7.7) and Generalized Anxiety Disorder-7 scale (9.4±6.7) were almost three times higher than those reported by studies of other Black populations in the United States. Five themes emerged: prolonged poverty and daily exposure to violence trigger emotional distress, mental health stigma affects help seeking, spirituality promotes mental relief and personal recovery, spirituality helps in coping with poverty and unsafe neighborhoods, and church-based programs are needed. CONCLUSIONS: Uptake of traditional mental health services was low, and reliance on faith and resource distribution by the church was high. Church-led interventions are needed to promote mental health at the individual and community levels. Mental health stigma, and negative attitudes toward mental health promotion in the community, may be addressed by integrating traditional mental health services in church-based recreational and leisure activities.
ABSTRACT
INTRODUCTION: African Americans (AA) have been disproportionately affected with the COVID-19 disease experiencing 30%-60% of the deaths, while only making up 13% of the US population. Early data suggest that pregnant women and those with cardiovascular disease (CVD) may experience worse outcomes with severe coronavirus infection. There is an urgent need to incorporate AA and female perspectives into the design of research on the CVD complications related to COVID-19. OBJECTIVES: The goal of this project was to incorporate perspectives of AA and female patients in developing research priorities and AN agenda related to COVID-19. Objectives included: (a) develop a strong, research-ready partnership capable of executing PCOR, (b) creation of a research agenda and a set of priorities on racial/sex-specific CVD disparities in COVID-19 which reflects the perspectives of AA's and women; (c) long-term objective is creation of a set of research questions suitable for clinical research using the AHA Registry. METHODS: The project used principles of active and adult learning within the framework of capacity building to build a strong, patient-centered vision of research needs. Different methods of obtaining patient input were used to identify questions suitable for research using the America Heart Association COVID-19 CVD Quality Improvement Registry: focus groups and town halls to identify concerns and interests vis-à-vis CVD and COVID research; narrative medicine methods collected compelling real-life, COVID-19 health stories; a research advisory council reviewed and prioritized research questions. RESULTS: Outcomes include a replicable method of obtaining patient-oriented input into the creation of a research agenda and a set of research priorities for COVID-19. Outputs include the establishment of a research advisory council and stakeholder training using the PCORI funded, PORTAL program resources; a catalogue of patient generated narratives on COVID-19 experiences in the voice of AAs and women, and a set of research questions suitable for research using the AHA Registry. CONCLUSION: The project created a research ready stakeholder network, ready to develop a research agenda about COVID-19.
