Office of Health Disparities Research

Addressing Health Disparities is Our Priority.

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Mon, Apr 29 1:47pm · Culturally relevant health app shows positive impact

LaPrincess Brewer, M.D., explaining heart health to a community member, using a hands-on model.

By Jay Furst

Mobile apps are popular sources of fast and easily digested consumer health information. But can they actually help in measurable ways to make you more healthy?

According to a pilot study by Mayo Clinic researchers, they can if the content is presented in a culturally relevant, targeted and engaging way — and in this case, it helps that the mobile health, or mHealth, intervention was developed in collaboration with the people who used it, within African American faith communities.

Dr. Brewer receives a demonstration of the app from David Derby, senior innovation project manager, Mayo Clinic Kern Center for the Science of Health Care Delivery.

Members of five African American church communities in Rochester, Minn., and the Minneapolis-St. Paul metro area, helped develop the app. The researchers then enrolled 50 African American adults in a 10-week study that included podcasts and multimedia educational modules on the app. Though the study was small in size, the intervention resulted in “several objectively measured positive outcomes for cardiovascular health,” according to the study, which was published online in March in the Journal of General Internal Medicine.

“This project was unique in that we used an unconventional app to develop a community-based health intervention — and we developed our intervention in partnership with the community,” says LaPrincess Brewer, M.D., a cardiologist in Mayo Clinic’s Department of Cardiovascular Medicine.

“The power and innovation of mobile health” was evident in the community engagement and outcome from this research prototype, says Dr. Brewer, the study’s first author. Participants “found it to be fun and engaging,” as well as contributing in measurable ways to their wellness.

Putting FAITH into action

The mHealth study was part of an innovative Mayo Clinic program called Fostering African-American Improvement in Total Health (FAITH), a participatory research effort aimed at preventing heart disease in underserved communities.

According to the American Heart Association, African Americans are significantly less likely than whites to meet five or more of seven factors that affect cardiovascular health. Those factors, which the association calls Life’s Simple 7 — diet, physical activity, smoking, body mass index, blood pressure, total cholesterol and fasting glucose — were used to assess the participants’ progress.

The study was conducted from October to December 2016, with follow-up assessments 28 weeks later. The study showed improvement in the biological measures, including blood pressure and total cholesterol, with significant improvement in the composite average for all seven factors.

“Our intervention, although a research prototype, offers an innovative medium to engage African American patients beyond office-based encounters through mobile technology with an overarching goal of diminishing cardiovascular disease risk and mortality,” the report says.

The study is believed to be the first to use a mobile health app as an intervention for improved  cardiovascular health among African Americans. A randomized controlled trial is the next step for assessing the model’s effectiveness, and Dr. Brewer says the app is being refined to make it “more user-friendly and more individualized to improve health behaviors.”

The app hasn’t been made available to the public, though Dr. Brewer says, “We are hoping that the mHealth lifestyle intervention will be available from the Mayo Clinic website for download, and for faith-based organizations national and internationally to use as a part of their health promotion programming.”

App reflects community input

The research is part of Mayo Clinic’s commitment to community-based participatory research that addresses health disparities. Coordinated by the Office of Health Disparities Research, similar collaborations with faith-based communities have been undertaken in Arizona and Florida.

One of the study participants, Clarence Jones, of Minneapolis, says, “The one emotion I have observed most from the participant groups is excitement — the excitement to see a product emerge from their input, and one that reflects their community and its values.”

Jones says the experience also was an opportunity for members to interact with researchers in a nontraditional way, where “their voice is being heard and considered before decisions are made. While this may seem like a simple thing, it is often not experienced by community members working with researchers.”

Another participant, Pamela Carter, of Roseville, Minn., says the 10-week intervention “made me more conscious of my daily activities. The constant reminders make this information a little more imprinted in your mind.”

Dr. Brewer’s work is supported by a grant from the National Institutes of Health and the Mayo Clinic Women’s Health Clinic. The study also was supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Center for Clinical and Translational Science, Department of Cardiovascular Medicine and Office of Health Disparities Research.

This article originally appeared on Advancing the Science.

Wed, Apr 24 11:43am · Mayo Clinic Pediatric Advisory Board to Empower Children

A Pediatric Advisory Boards (PAB) has been convened with a goal to provide feedback to Mayo Clinic investigators on studies conducted with the pediatric community at Mayo Clinic. The PAB is supported by the Mayo Clinic Center for Clinical and Translational Science (CCaTS) within the Community Engagement Program and Special Populations Programs. The CCaTS PAB will assist Mayo Clinic researchers to ensure that pediatric research represents the major health concerns of youth, respects the ability of youth to assent to participate in research, and benefits the health of youth. The overall goals of the Board will be to: review and advise Mayo Clinic biomedical researchers on pediatric research studies, represent the needs of the youth in the local community, increase research literacy of youth, increase participation in biomedical research at Mayo Clinic, engage local youth in determining the health and wellness needs to increase health equity and reduce health disparities, create and convene a sustainable group of youth to engage in thought dialogs about biomedical research, build capacity and partnerships of youth based organizations to partner with Mayo Clinic biomedical Research, ask PAB members to advise researchers on the best practices when conducting biomedical research with youth, have PAB members help identify other community members and partners that should be represented on the Pediatric Advisory Board.

Please contact Miguel Valdez Soto to learn more about the Pediatric Advisory Board.

Wed, Apr 24 11:38am · My Life Matters: Mammogram for Life!

Breast cancer is the most common cancer in Minnesota women. Tribal women of the Northern Plains Region of the Indian Health Services region have higher mortality rates (26.2 vs 22.8 per 100,000) and higher mortality rates across every age (0-31 years to 65 and older), compared to the region’s non-Hispanic white women. The mortality to incidence ratio (0.23 vs. 0.18) shows that American Indian women in the region are more likely to die from the disease than are non-Hispanic white women.

Mayo Clinic researcher Wesley Petersen, Ph.D., Director of OHDR-Native American Research Outreach, partnered with Red Lake Comprehensive Health Services, and Red Lake Indian Health Service (IHS) to reduce late-stage breast cancer through increasing American Indian women’s participation in mammograms and increasing adherent participation (obtaining an annual mammogram beginning at age 40).

The research, funded by Minnesota Department of Health, Center of Health Equity, involved promoting mammograms through tribe-specific, low-tech messaging using elements from five theoretical models of health behavior. Messaging formats included posters, videos, promotional materials, and events celebrating life.

As an outcome of this study, the average Mammogram adherence in Women > 40 years of age increased beyond the goal of 20%. Source

Fri, Apr 12 1:15pm · Listening to the needs of faith communities -- Research from the ground up

Church members completed a two-mile walk around Rochester, Minnesota, to celebrate the 10-year anniversary of the FAITH! program in 2018.

What if a team of researchers came into your neighborhood to develop healthy living programs — tailored just for you?

Mayo Clinic is collaborating with communities in just this way, using research as a bridge to better health. Coordinated by Mayo Clinic’s Office of Health Disparities Research, teams are using a methodology called community-based participatory research to collaborate with faith communities in Minnesota, Florida and Arizona.

Collaborating with African-American churches to improve health in Minnesota
In many African-American communities, church is at the center of spiritual and social life. Nearly half of African-Americans (47 percent) attend services at least weekly, according to the Pew Research Center.

In 2013, Mayo Clinic cardiologist LaPrincess Brewer, M.D., was invited by members of a Rochester, Minnesota, church to help them address a specific concern: cardiovascular disease — the No. 1 cause of death for African-Americans.

LaPrincess Brewer, M.D.

Partnering with three churches, Dr. Brewer’s team developed a 16-week educational program to improve prevention of cardiovascular disease. The Fostering African-American Improvement in Total Health (FAITH!) program, previously established by Dr. Brewer in Baltimore, Maryland, focuses on healthy lifestyle promotion.

Within the FAITH! program, Dr. Brewer used an American Heart Association’s strategy called Life’s Simple 7 that targets major cardiovascular risk factors: diet, smoking, physical inactivity, obesity, hypertension, diabetes and cholesterol.

Church members were the primary voice for deciding not only the goal of the research collaboration, but where, when and how to achieve it. In particular, church leaders requested that the program incorporate African-American traditions.

FAITH! included healthy cooking demonstrations focused on Southern dishes, and participants received a cookbook of low-fat, low-calorie recipes customized to traditional African-American cuisine.

The program also included interactive seminars by health professionals, weekly fitness classes, and videos on heart health topics. As incentives, participants received gift cards to a local supermarket, and YMCA memberships.

The researchers used questionnaires and health data to measure how well these interventions worked. At the outset, data showed that the community members matched the African-American population in general, with high risk factors for cardiovascular disease, and high rates of obesity and hypertension. At the end of the study, participants showed an increase in cardiovascular health knowledge, and better scores related to the Life’s Simple 7 risk factors. The results were published in the Journal of Racial and Ethnic Health Disparities and the Journal of Health Psychology.

Church members wanted a way to share the health education information with family and friends, so the researchers developed a mobile health (mHealth) intervention ­— an app featuring multimedia education modules and a participant “sharing board.” Results of a pilot study were published in JMIR Research Protocols and the Journal of General Internal Medicine.

The mHealth intervention supports sustainability of FAITH! and has made the program readily adaptable for distribution in any community. The program has now expanded to the Minneapolis-St. Paul area.

Working with churches is a unique and fulfilling experience — and a “symbiotic partnership” that requires an investment in face time, says Dr. Brewer. “If we would have just skipped over that step and come in with a research project, surveys, lab draws and exams — without developing a relationship with the congregation, we would not have been as successful. … They grew to know me, saw my face consistently, and knew that I had their best interests at heart.”

The FAITH! program has laid the foundation for sustainable partnerships between the African-American churches and Mayo Clinic, as well as the University of Minnesota at Rochester. The project has also provided leverage for other Mayo researchers to become involved in community-based participatory research.

Richard White, M.D.

Responding to unmet needs in Hispanic communities in Florida
When it comes to collaborating with communities, Mayo Clinic researcher Richard White, M.D., has a word of advice: “You have to listen before you speak,” he says.

Dr. White recently surveyed a group of faith-based organizations in Hispanic communities in Jacksonville, Florida, with assistance from clinical research coordinator Elizabeth Pantoja. The survey was part of Mayo Clinic’s Health Outreach Program en Español (HOPE), a collaborative initiative with churches and other local organizations to bring health education and research to the Hispanic community.

While Dr. White and his team were focused primarily on diabetes and obesity, they learned from the survey that mental health is also a priority. “Sometimes as researchers, we can have a superman mentality, thinking that we know what our community needs,” says Dr. White. “We’ve learned that you have to respond to the needs of the community.”

Hispanics bear a high burden of diabetes. According to the Centers for Disease Control and Prevention, Hispanic people are about 50 percent more likely than whites to die from diabetes, more than half will be diagnosed with type 2 diabetes in their lifetimes.

In 2015, Mayo Clinic researchers in Florida began connecting with faith-based organizations to look for potential areas to collaborate.

Over the next year and a half, the researchers spent a lot of time in churches and community spaces. “One of the lessons that our team has learned is that you have to gain trust,” says Dr. White. “We’re trying to help people in our region understand that at Mayo Clinic, we are interested in these health equity issues, and that we have a lot of activities going on to try and address them.”

Floyd Willis, M.D.

The team now partners with over 20 faith-based organizations. Dr. White recently received a grant from the Patient-Centered Outcomes Research Institute (PCORI) to build capacity for the program. This work will include creating a community advisory panel that will help Dr. White and his team to develop a training module for faith leaders and other Hispanic-serving stakeholders in research methodology. In May 2020, the researchers will hold a communitywide event, called Jax Saludable, to give the trained faith leaders and stakeholders a hands-on experience with connecting the community to research opportunities and health education.

Improving patient care in African-American communities in Florida
Mayo Clinic family researcher Floyd Willis, M.D., with assistance from program manager Monica Albertie, has launched a research program in collaboration with the University of Florida to reduce the rates of obesity, hypertension and stroke in African-American communities.

Floyd Willis, M.D., leads a discussion with community members.

The researchers will implement the University of Florida’s Health-Smart Behavior Program (Health-Smart) at six churches, for 30 community members who are overweight or obese. The program aims to arm participants with strategies for “heart-smart” behaviors — healthy eating, physical activity, and stress and depression management — as well as to increase how often they access needed health care services.

By comparing before and after data, communities can zoom in on which interventions are making the most difference — and where gaps may lie. The research team will also help churches create sustainability plans.

“The best solutions for improving patient care in the underserved community will come from the underserved community,” Dr. Willis says. “The research, as wonderful as it is from academic medical institutions, can’t do it alone. The best and possibly only way to leverage this research is through the community — with those community ties, support and buy-in; and with that community base.”

Christopher Pullins, M.D.

Opening the door for minority participation in research in Arizona
Mayo Clinic researchers Yonas Geda, M.D., and Christopher Pullins, M.D., collaborated with an African-American church community in Arizona to conduct a feasibility study on how physical activity levels may affect cognitive function.

Participants took a computerized cognitive test that measured their reaction times and short-term memory. The researchers also measured their resting energy expenditure, and tracked their activity levels. Some participants were chosen at random to receive free memberships to a fitness club to encourage their physical activity.

The researchers found a trend between higher cognitive functioning and greater physical activity. “These findings have encouraged community members to remain physically active,” says Dr. Pullins. The research team plans to explore the possibility of further collaboration with this community.

Studies such as this help open the door for minorities to participate in research. 2015 census data indicates that minorities make up about 40 percent of the population, yet they represent only about 19 percent of participants in clinical trials, according to the U.S. Food and Drug Administration. This gap can undermine the applicability of results to these groups. Underserved populations may also miss out on benefits of research participation — such as resources made available to communities, and the opportunity to try promising new therapies.

Since 2015, the Office of Health Disparities Research has partnered with Mayo Clinic’s Community Engagement in Research Program to sponsor community members and Mayo Clinic staff to attend the annual Healthy Churches 2020 Conference. At this event, Drs. Brewer and Pullins have led a workshop on methods to recruit African-Americans to participate in research.

Highlighting the needs of church leaders
At the Healthy Churches 2020 Conference in 2016, an enterprise team of Mayo researchers collaborated with the Balm in Gilead, Inc., to conduct a survey of the attendees, who are predominantly African-American church and healthy ministry leaders. The team found that self-reported health behaviors of participants was suboptimal — highlighting the need to promote self-care and health and wellness among those in faith communities who are running health ministries. The study was published in the Journal of Religion and Health.

Through its many efforts in Minnesota, Florida and Arizona, Mayo Clinic is collaborating with churches and church ministries to reach minority communities and reduce their burden of health disparities. Dr. Brewer says, “Showing that we can go into this community, that we have not traditionally reached out to, and develop sustainable relationships is important and going to revolutionize how Mayo practices community medicine.”

— Kris Schanilec, Mayo Clinic Public Affairs

Thu, Feb 28 4:21pm · Help for Native American patients at Mayo Clinic

Valerie DeCora Guimaraes, will be presenting on her role as the first Patient Relations Specialist at Mayo for Native American patients seeking health and healing. Valerie is an enrolled member of the Ho-Chunk Nation, with Dakota ancestry. She has been an RN for 20+ years, and has worked in med-surg, neuro, rehab, public health, and served as an adjunct professor in the clinical setting. She earned her bachelor degrees in nursing and physiology at WSU and the U of M. She earned her master’s degree from Lesley University in Interdisciplinary Studies – Research Methodology and Historical Research. Valerie has served on Human Rights Commissions for 15 years: in Winona and Bemidji, MN. She has served as a member and as the Chairwoman of both of these commissions.

Valerie has written several articles, essays and books, and continues to write stories and commentaries on indigenous life. Social justice issues are a passion, and through this, Valerie has initiated several projects: Give Them Hope, Project Sylvia, and the Native American Family Fund.

Valerie is currently a member of the Native American Nurses Association, the Native American Women’s Network Association, and is on the board of the Rochester International Association. Valerie also is a member of the RACE Advisory Council through the Science Museum of MN. Valerie has also co-founded the non-profit GRADS, which provides education to better understand the Dakota cultural and traditions to the greater Rochester Community.

Valerie is currently employed as a Patient Relations Specialist who works with Native American patients seeking health and healing here at Mayo.

Date: Tuesday March 12, 2019

Time: Noon to 1:00 pm CST

Rochester Location: Baldwin 01-507

Connection Information: Call-in information:
Number: 866-365-4406
Code: 2844575

Blackboard Connection:

https://us.bbcollab.com/guest/6A973C690E9BEEF680897DDD7F9ED9C4

**Use Google Chrome or Mozilla Firefox if possible

 RSVP To Wes Petersen by 3/7/19 via:

Email: peterw@mayo.edu

Phone: 507-266-2204

**Box lunches will be available for those attending in Rochester.

This Event is Open to the Public

Thu, Feb 28 8:19am · Mayo Clinic Cardiology Researcher Heralded as a 'Change Maker'

Minnesota Public Radio (MPR) News is featuring Black Minnesotans making history every weekday in February to celebrate Black History Month. The news agency featured LaPrincess C. Brewer, M.D., M.P.H., as part of the series. Dr. Brewer, a health disparities researcher working in the field of Preventative Cardiology, focuses her work on devising strategies to reduce heart health disparities in minority and underserved populations through her Fostering African American Improvement in Total Health (FAITH) research program in Rochester and Twin Cities. Dr. Brewer partners with leaders of health ministries and members of various congregations to  develop healthy living programs tailored specifically for their health concerns

In the interview Dr. Brewer states that growing up she witnessed several of her church members dying at a young age due to complications related to heart disease. Her research program is a way to give back to her community by collectively developing strategies to establish a culture of health.

Dr. Brewer’s MPR interview aired on Feb. 21, 2019.

Mon, Feb 18 1:41pm · The Role of the Black Church in Public Health

Mayo Cardiologist, La Princess Brewer MD, co-authored an editorial with Dr. David Williams (the most published health disparities scholar) in the March issue of American Journal of Public Health. The editorial, part of the March issue on Faith-Based Organization and Public Health Practice, discusses the role, reach, and influence of faith-based institutions in the African American community and the underserved populations to which they minister. Dr. Williams invited Dr. Brewer to co-author the article.  He was the keynote at OHDR’s 2017 Retreat, where Dr. Brewer presented her work on outreach collaboration with The Balm in Gilead, Inc., a non-profit capacity-building organization focused on health ministries in black churches. Dr. Brewer has a strong partnership with African American churches in Rochester, focused on improving cardiac health of parish members through her FAITH! research program.  ARTICLE

 

Mon, Feb 18 9:47am · Mayo Clinic Platinum Sponsor for Cancer Summit Minnesota 2019

The Minnesota Cancer Alliance (MCA) will host its 2019 Cancer Summit on Thursday, February 28, 2019 at the McNamara Alumni Center, University of Minnesota, in Minneapolis.  The Office of Health Disparities Research (OHDR) and Mayo Clinic’s Cancer Center have jointly contributed to Mayo Clinic’s Platinum Sponsorship of the event.  The Summit gives attendees—who represent a wide range of medical professionals, public health agencies, non-profit organizations, and health advocates—a chance to meet and dialogue with others interested in reducing the burden of cancer for all Minnesotans. Presenters at this year’s Summit will include Keynote Speaker Archelle Georgiou, MD, a health-consumer education advocate who, as an on-air medical expert for over a decade, has covered more than 1,100 different topics, and Health Equity Plenary Speaker Vayong Moua, Director, Health Equity Advocacy, Blue Cross.  The Summit will also provide significant opportunities, in plenary, breakout, and networking sessions, to learn more about the common goals of Cancer Plan Minnesota 2025, the state’s framework for action in cancer prevention, diagnosis, treatment, and cure. This year, for the first time, the Summit will be videocast to locations in Bemidji and St. Peter, MN.  “The remote broadcast of the Summit will allow for much greater attendance, especially by rural providers and participants,” notes Sumedha Penheiter, PhD, Program Manager for OHDR, who, along with HSR researcher Carmen Radecki Breitkopf, PhD, serves on the MCA Steering Committee.  Space is still available.  MORE INFORMATION

 

 

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