This document describes a study to develop and test a new peer support model to reduce cardiovascular disease risk among African American men. The study will involve five phases: 1) education, 2) health screening, 3) blood pressure monitoring, 4) a 6-month peer support intervention, and 5) follow up. The intervention uses small group support and technological tools like text messaging to encourage healthy behaviors. It will be tested at two churches and measure outcomes like blood pressure, cholesterol, and diet. The goal is to improve health and lower community cardiovascular disease risk through behavior change support from peers and role models in the churches.

1. Developing and Testing a New
Model to Reduce Risk for
Heart Disease and Stroke
PI: Ruth Lindquist, PhD, RN, FAAN, Professor
University of Minnesota ,School of Nursing
Partner: National USA Foundation, Inc. (NUFI)
Rev./Dr. LB West, Mount Airy Baptist Church, Washington, D.C.

2. A. Significance
AA men live
4 year less
than their
Caucasian
counterparts
CVD in
large part a
behavioral
disease
Men are
viewed
within the
context of
their
community

3. B. Innovation
Novel Peer Group
Support
Mechanism
• Okinawan “Moai”
• Increasing level
of accountability,
encouragement,
and salutary,
enduring health
behavior change
Use of
Technological tools
• Smart phone
• Physical activity
tracker
• Text messaging
Audio Recording
• Graining insight
into change
processes and
support for
behavior change
among peer
groups

4. B. Innovation
↑Awareness
Education
Personal risk
(screening)
↑Activation
Ready to
change
Demonstrated
commitment
(run-in)
↑Awareness
Effort to
change
Outcomes
↑Knowledge
Improved health
behaviors
Improved health
Reduced CVD risk
+ Role modeling
+ Culture impact
↓Community
CVD risk
Intervention
Goal
setting
Education Inspiration Ongoing
Feedback
“tracking”
Peer
support
advice
Community
CVD risk
Conceptual Model

5. C1. Preliminary work
• “SOAR”: church initiated health program
• 10-week behavioral weight loss program
• 16-week text messaging and small peer group weight
management program
• Qualitative Interviews of weight loss program
C2. Justification and Feasibility
• Life’s Simple 7
• Community partners
C. Approach

6. Subjects and Setting
C.3. Research Design
Phase I (Education)
Inclusion:
Men, 40-70 year old, who
identify as AA, able to read and
write in English and provide
informed consent and who are
members.
Setting:
New Salem Missionary Baptist
Church ( n ≈ 700)
Mount Airy Baptistic Church (n
≈ 300)
Phase II and III (Screening & BP) “Run-In”
Added inclusion:
Having a health activation score
in the upper 50th percentile
Exclusion:
Active smoker, illicit drug users,
and men with alcoholism or
psychiatric illness
Phase IV and V (Support)
Inclusion:
Having one or more risks for
CVD according to AHA
guideline Life’s Simple 7;
compliance shown in attending
weekly BP checks; health
activation reflecting readiness
to or contemplation of health
behavior change; willingness to
commit time to 6-month
program and be randomized.

7. Subjects and Setting – Performance sites
C.3. Research Design

8. Performance sites
C.3. Research Design
New Salem Missionary
Baptist Church
Minneapolis, MN
Mount Airy Baptist Church
Washington D.C
Pastor: Jerry McAfee Pastor: Rev. L. B. West, D.R.S.

9. C.4. Measures
I. Primary Outcome Measures
(Life’s Simple 7)
Total
Cholesterol
Blood
Pressure
Blood
Glucose
Physical
Activity
Health diet
score
Obesity Smoking

10. C.4. Measures
II. Psychosocial and Behavioral
Measures
Stage of
Change/
Readiness
to Change
Dietary
Knowledge
Healthy
Eating
Change
Strategies
Framingham
Coronary
Heart
Disease
Risk Score
Self-
reported
current
smoking
Self-rated
Health
BRFSS 4-
item activity
scale
General
Food
Knowledge
Questionnai
re
Physical
Activity
My Fitness
Pal
III. Biometric
Measures
Blood
pressures
Bloods
IV.
Anthropologic
Measures
Weight Height BMI

11. C.5. Intervention Model Phases
Phase I
Education
Video
Presentation
Phase II
Health
Screening
30-40 men
Health
activation will
be assessed
Consent and
Measures
Phase III
Blood
Pressure
Run-In
3-week Blood
pressure check
Recruit to
enroll in the 6-
month program
Phase IV
6-month small
group support,
education, and
behavioral
change
Weekly -> Bi-
weekly ->
Monthly
Phase V
Follow-up
2 month after
the end of
Phase IV

12. C.5. Small groups
Video
presentation
Life’s Simple 7
Trained
Facilitator
Invisible
RA

13. Timeline of Study Activity
September October –
November
December - May June July - August
Planning &
Development
Follow-up Grant
Development
Phase I
Congregational
Education &
Measures
Follow-up
Congregational
Measures
Phase II
Biometric
Screening
Post Biometric
Screening
Phase III BP
“Run-In”
Baseline
Measures
Phase IV Behavioral Change
Intervention & RCT
Post Intervention
Measure
Phase V
Follow-Up
Study Analyses,
Model Revision

14. Thank you!