The Role of Social Support in Cardiovascular Clinical Trial Participation among Black Men: Black Impact.

BACKGROUND: Attainment of the American Heart Association's Life's Simple 7 (LS7) metrics reduces cardiovascular disease (CVD) risk; yet, Black Americans have the lowest LS7 attainment among all communities, the highest rate of CVD mortality, and low clinical trial participation. Social support is positively correlated with chronic disease self-management. Here, we describe the role of social support in a single-arm pilot clinical trial of a community-based lifestyle intervention among Black American men. METHODS: The 24-week intervention featured weekly team-based physical activity and LS7-themed education. Seventy-four Black men participated in the intervention; twenty agreed to participate in exit surveys via one of three semi-structured focus groups. Data were transcribed verbatim and analyzed using content analysis framed by House's social support framework. RESULTS: Participants reported support from both peers and health coaches. The sub-themes of social support among peers were: (1) acknowledgement, understanding, and validation, (2) inspiration, (3) sense of community, (4) fear of disappointing fellow participants, and (5) group synergy. The sub-themes of social support from the health coaches and study team staff included: (1) contemplation of current health status, (2) racial concordance of health coaches and study team staff, (3) investment of the research team, (4) incentives, (5) access to healthcare providers, and (6) the COVID-19 pandemic. Emotional support was the most frequently discussed theme. CONCLUSIONS: Social support, especially emotional support, from peers and health coaches was a driver of clinical trial participation among participants. The intervention created a positive social environment and decreased medical mistrust. This intervention may provide a framework by which to facilitate clinical trial participation among Black men.

What Differences Do They See? Using Mixed Methods to Capture Adolescent Perceptions of Neighborhood Contexts.

Recent neighborhood research emphasizes the importance of individuals' perceptions of their neighborhoods, as well as expands the definition of "neighborhood" to include the different contexts encountered during routine daily activities (Coulton et al., 2013; Kwan, 2012). The present study uses qualitative interviews, sketch mapping, and survey data to explore adolescents' experiences of different neighborhoods within their activity space. Participants included 55 racially diverse youth aged 11-19 (M = 14.64, SD = 2.33) who resided in low-income neighborhoods in a small city in the Midwest. The majority reported spending time in multiple self-defined neighborhoods, noting significant differences between neighborhoods on collective efficacy, street code, and on participant-generated dimensions. Self-defined neighborhoods did not correspond to Census tracts, and Census indicators were not associated with youth's perceptions (e.g., collective efficacy, street code). Youth spent time in neighborhoods that differed significantly on multiple Census indicators of structural disadvantage, though within-individual differences tended to be small in magnitude. Type of routine activity was largely not predictive of distance traveled from home, though some findings suggest youth were more likely to cross neighborhood boundaries to engage in structured activities compared to different unstructured activities. Implications for neighborhood research and interventions are discussed.