Tracy J Yang1, Lisa A Cooper2, L Ebony Boulware3, Rachel L J Thornton4. 1. New York-Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York. 2. Division of General Internal Medicine, Johns Hopkins Hospital and Health System, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Center for Health Equity, Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 3. Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Chapel Hill, North Carolina. 4. Department of Pediatrics, Johns Hopkins Hospital and Health System, Johns Hopkins Center for Health Equity, Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland.
Abstract
Purpose: Few family-oriented cardiovascular risk reduction interventions exist that leverage the home environment to produce health behavior change among multiple family members. We identified opportunities to adapt disease self-management interventions included in a blood pressure control comparative effectiveness trial for hypertensive African American adults to address family-level factors. Methods: We conducted and analyzed semi-structured interviews with five intervention study staff (all study interventionists and the study coordinator) between December 2016 and January 2017 and with 11 study participants between September and November 2015.1 All study staff involved with intervention delivery and coordination were interviewed. We sampled adult participants from the parent study, and we analyzed interviews that were originally obtained as part of a previous study based on their status as a caregiver of an adolescent family member. Results: Thematic analysis identified family influences on disease management and the importance of relationships between index patients and family members, between index patients and study peers, and between index patients and study staff through study participation to understand social effects on healthy behaviors. We identified four themes: 1) the role of family in health behavior change; 2) the impact of family dynamics on health behaviors; 3) building peer relationships through intervention participation; and 4) study staff role conflict. Conclusions: These findings inform development of family-oriented interventions to improve health behaviors among African American index patients at high risk for cardiovascular disease and their family members.
Purpose: Few family-oriented cardiovascular risk reduction interventions exist that leverage the home environment to produce health behavior change among multiple family members. We identified opportunities to adapt disease self-management interventions included in a blood pressure control comparative effectiveness trial for hypertensive African American adults to address family-level factors. Methods: We conducted and analyzed semi-structured interviews with five intervention study staff (all study interventionists and the study coordinator) between December 2016 and January 2017 and with 11 study participants between September and November 2015.1 All study staff involved with intervention delivery and coordination were interviewed. We sampled adult participants from the parent study, and we analyzed interviews that were originally obtained as part of a previous study based on their status as a caregiver of an adolescent family member. Results: Thematic analysis identified family influences on disease management and the importance of relationships between index patients and family members, between index patients and study peers, and between index patients and study staff through study participation to understand social effects on healthy behaviors. We identified four themes: 1) the role of family in health behavior change; 2) the impact of family dynamics on health behaviors; 3) building peer relationships through intervention participation; and 4) study staff role conflict. Conclusions: These findings inform development of family-oriented interventions to improve health behaviors among African American index patients at high risk for cardiovascular disease and their family members.
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