Alvarado Flor, Hercules Amanda, Wanigatunga Melanie, Laurent Jodie, Payne Marilyn, Allouch Farah, Crews Deidra C, Mills Katherine T, He Jiang, Gustat Jeanette, Ferdinand Keith C
Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Ste 2001, New Orleans, LA 70112, USA.
Am Heart J Plus. 2023 Feb 15;27:100273. doi: 10.1016/j.ahjo.2023.100273. eCollection 2023 Mar.
Few church-based health interventions have evaluated the influence of neighborhood-level social determinants of health (SDOH) on adopting heart-healthy lifestyles; none has occurred in Louisiana. We aimed to characterize neighborhood-level SDOH that may influence the ability to adopt a heart-healthy lifestyle among Black community church members in New Orleans, LA.
This mixed methods study used quantitative data (surveys) and qualitative data (focus groups) to explore SDOH at the neighborhood- and church-area- level, including factors related to the physical (e.g., walkability, accessibility to recreational facilities) and social (e.g., social cohesion, perceived safety) environments. Descriptive analyses were conducted for quantitative data. Qualitative data were coded and analyzed using grounded theory and thematic analysis.
Among survey respondents ( = 302, 77 % female, 99 % Black), most reported having walkable neighborhood sidewalks and high neighborhood social cohesion. Two-thirds did not feel violence was a problem in their neighborhood and felt safe walking, day, or night. Focus group participants ( = 27, 74 % female, 100 % Black) reported facilitators to heart-healthy living, including social support promoting physical activity, intentionality in growing, buying, and preparing produce, and the neighborhood-built environment. Reported barriers included: crime, the COVID-19 pandemic, individual-level factors limiting physical activity, and city-wide disparities influencing health. Participants discussed strategies to promote healthy living, centered around the theme of establishing and rebuilding community relationships.
Future health interventions aimed at improving cardiovascular outcomes among church communities should continue to inquire about neighborhood-level SDOH and tailor interventions, as appropriate, to address barriers and leverage facilitators within these communities.
很少有基于教会的健康干预措施评估邻里层面的健康社会决定因素（SDOH）对采用心脏健康生活方式的影响；路易斯安那州尚未有此类研究。我们旨在描述可能影响路易斯安那州新奥尔良市黑人社区教会成员采用心脏健康生活方式能力的邻里层面SDOH。
这项混合方法研究使用定量数据（调查）和定性数据（焦点小组）来探索邻里和教会区域层面的SDOH，包括与物理环境（如步行便利性、娱乐设施可达性）和社会环境（如社会凝聚力、感知安全性）相关的因素。对定量数据进行描述性分析。定性数据采用扎根理论和主题分析进行编码和分析。
在调查受访者中（n = 302，77%为女性，99%为黑人），大多数人报告所在社区的人行道适合步行且社区社会凝聚力高。三分之二的人认为暴力在他们的社区不是问题，白天或晚上行走都感到安全。焦点小组参与者（n = 27，74%为女性，100%为黑人）报告了心脏健康生活的促进因素，包括促进身体活动的社会支持、种植、购买和准备农产品的意愿，以及社区建成环境。报告的障碍包括：犯罪、新冠疫情、限制身体活动的个人层面因素，以及影响健康的全市范围差异。参与者讨论了促进健康生活的策略，围绕建立和重建社区关系这一主题展开。
未来旨在改善教会社区心血管结局的健康干预措施应继续询问邻里层面的SDOH，并酌情调整干预措施，以解决这些社区中的障碍并利用促进因素。
