The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors

Abstract Background AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at p...

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Autores principales:	Michelle J. White, Katelyn M. Holliday, Stephanie Hoover, Nicole Robinson-Ezekwe, Giselle Corbie-Smith, Anissa Williams, Kiana Bess, Leah Frerichs
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cardiovascular disease Social and built environment Geography Health disparities Qualitative methods Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/8e8993e37d46490a841915167f7b3fb2
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spelling	oai:doaj.org-article:8e8993e37d46490a841915167f7b3fb22021-11-08T10:44:00ZThe significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors10.1186/s12889-021-12022-x1471-2458https://doaj.org/article/8e8993e37d46490a841915167f7b3fb22021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12022-xhttps://doaj.org/toc/1471-2458Abstract Background AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults’ self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking. Methods We conducted semi-structured interviews with AA adults (N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12. Results The average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives’ homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives’ homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support. Conclusions As we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.Michelle J. WhiteKatelyn M. HollidayStephanie HooverNicole Robinson-EzekweGiselle Corbie-SmithAnissa WilliamsKiana BessLeah FrerichsBMCarticleCardiovascular diseaseSocial and built environmentGeographyHealth disparitiesQualitative methodsPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cardiovascular disease Social and built environment Geography Health disparities Qualitative methods Public aspects of medicine RA1-1270
spellingShingle	Cardiovascular disease Social and built environment Geography Health disparities Qualitative methods Public aspects of medicine RA1-1270 Michelle J. White Katelyn M. Holliday Stephanie Hoover Nicole Robinson-Ezekwe Giselle Corbie-Smith Anissa Williams Kiana Bess Leah Frerichs The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors
description	Abstract Background AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults’ self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking. Methods We conducted semi-structured interviews with AA adults (N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12. Results The average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives’ homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives’ homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support. Conclusions As we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.
format	article
author	Michelle J. White Katelyn M. Holliday Stephanie Hoover Nicole Robinson-Ezekwe Giselle Corbie-Smith Anissa Williams Kiana Bess Leah Frerichs
author_facet	Michelle J. White Katelyn M. Holliday Stephanie Hoover Nicole Robinson-Ezekwe Giselle Corbie-Smith Anissa Williams Kiana Bess Leah Frerichs
author_sort	Michelle J. White
title	The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors
title_short	The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors
title_full	The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors
title_fullStr	The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors
title_full_unstemmed	The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors
title_sort	significant places of african american adults and their perceived influence on cardiovascular disease risk behaviors
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8e8993e37d46490a841915167f7b3fb2
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The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors

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