Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study
Abstract Background African Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To...
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BMC
2025-01-01
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| Series: | Implementation Science Communications |
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| Online Access: | https://doi.org/10.1186/s43058-024-00692-8 |
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| author | Amelia DeFosset Breanna Deutsch-Williams Mysha Wynn Katrina Blunt Scott Rosas Mary Wolfe McKinley Brian Ellerby Shirley McFarlin Veena Reddy Giselle Corbie Gaurav Dave |
| author_facet | Amelia DeFosset Breanna Deutsch-Williams Mysha Wynn Katrina Blunt Scott Rosas Mary Wolfe McKinley Brian Ellerby Shirley McFarlin Veena Reddy Giselle Corbie Gaurav Dave |
| author_sort | Amelia DeFosset |
| collection | DOAJ |
| description | Abstract Background African Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To understand how to implement and sustain evidence-based CVD programs at scale, we must explore the perspectives of organizations serving rural African American communities and situate findings within foundational Implementation Science frameworks. Methods This study used group concept mapping (GCM) to elicit and synthesize stakeholder perspectives into an action-focused conceptual model depicting factors influencing implementation of evidence-based CVD programs. Representatives of community-based, faith, and healthcare organizations serving African Americans in five rural North Carolina counties were recruited via purposive sampling techniques. Participants (total n = 31) completed three activities: 1) brainstorming in response to an open-ended prompt (n = 31); 2) sorting brainstorm data into wider concepts and rating each in terms of relative importance and feasibility (n = 26); and 3) collaborative interpretation and refinement of the concept map (n = 19). Multivariate statistical analysis was used to generate a concept map. Absolute pattern matches comparing ratings of the relative importance and feasibility of each factor were generated and depicted via ladder graphs. Results The final concept map included five factors: Accessibility, Community and Social Factors, Education and Training, Financial/Resource Development, and Organization Capacity and Staffing. There was high agreement (r = .98) between ratings of importance and feasibility. Education and Training, both within organizations and the wider community, was rated as the most important and feasible factor and Financial/Resource Development was the least important and feasible. Conclusions The concept map emphasizes aspects of organizations (inner setting), their surrounding community (outer setting), and individual stakeholders (participants, implementers) as influencing implementation of evidence-based CVD prevention and management programs in rural African American communities. The nature of the intervention or implementation processes were de-emphasized. Organizations in rural African American communities may feel equipped to implement a range of evidence-based programs, provided strategies address the contextual and structural barriers that impede their success. Group concept mapping helped distill and prioritize initial leverage points for action in our project catchment area by facilitating a community-engaged process of data generation and interpretation. |
| format | Article |
| id | doaj-art-1619c34079b74a1e8d22f847a4434a5d |
| institution | Kabale University |
| issn | 2662-2211 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj-art-1619c34079b74a1e8d22f847a4434a5d2025-01-19T12:25:32ZengBMCImplementation Science Communications2662-22112025-01-016111110.1186/s43058-024-00692-8Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping studyAmelia DeFosset0Breanna Deutsch-Williams1Mysha Wynn2Katrina Blunt3Scott Rosas4Mary Wolfe McKinley5Brian Ellerby6Shirley McFarlin7Veena Reddy8Giselle Corbie9Gaurav Dave10Center for Health Equity Research, School of Medicine, University of North Carolina at Chapel HillCenter for Health Equity Research, School of Medicine, University of North Carolina at Chapel HillProject Momentum IncorporatedProject Momentum IncorporatedConcept Systems IncorporatedCenter for Health Equity Research, School of Medicine, University of North Carolina at Chapel HillOpportunities Industrialization CenterJames McFarlin Community Development, IncCenter for Health Equity Research, School of Medicine, University of North Carolina at Chapel HillCenter for Health Equity Research, School of Medicine, University of North Carolina at Chapel HillCenter for Health Equity Research, School of Medicine, University of North Carolina at Chapel HillAbstract Background African Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To understand how to implement and sustain evidence-based CVD programs at scale, we must explore the perspectives of organizations serving rural African American communities and situate findings within foundational Implementation Science frameworks. Methods This study used group concept mapping (GCM) to elicit and synthesize stakeholder perspectives into an action-focused conceptual model depicting factors influencing implementation of evidence-based CVD programs. Representatives of community-based, faith, and healthcare organizations serving African Americans in five rural North Carolina counties were recruited via purposive sampling techniques. Participants (total n = 31) completed three activities: 1) brainstorming in response to an open-ended prompt (n = 31); 2) sorting brainstorm data into wider concepts and rating each in terms of relative importance and feasibility (n = 26); and 3) collaborative interpretation and refinement of the concept map (n = 19). Multivariate statistical analysis was used to generate a concept map. Absolute pattern matches comparing ratings of the relative importance and feasibility of each factor were generated and depicted via ladder graphs. Results The final concept map included five factors: Accessibility, Community and Social Factors, Education and Training, Financial/Resource Development, and Organization Capacity and Staffing. There was high agreement (r = .98) between ratings of importance and feasibility. Education and Training, both within organizations and the wider community, was rated as the most important and feasible factor and Financial/Resource Development was the least important and feasible. Conclusions The concept map emphasizes aspects of organizations (inner setting), their surrounding community (outer setting), and individual stakeholders (participants, implementers) as influencing implementation of evidence-based CVD prevention and management programs in rural African American communities. The nature of the intervention or implementation processes were de-emphasized. Organizations in rural African American communities may feel equipped to implement a range of evidence-based programs, provided strategies address the contextual and structural barriers that impede their success. Group concept mapping helped distill and prioritize initial leverage points for action in our project catchment area by facilitating a community-engaged process of data generation and interpretation.https://doi.org/10.1186/s43058-024-00692-8Cardiovascular diseaseEvidence-based programsImplementationGroup concept mappingCommunity-engaged research |
| spellingShingle | Amelia DeFosset Breanna Deutsch-Williams Mysha Wynn Katrina Blunt Scott Rosas Mary Wolfe McKinley Brian Ellerby Shirley McFarlin Veena Reddy Giselle Corbie Gaurav Dave Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study Implementation Science Communications Cardiovascular disease Evidence-based programs Implementation Group concept mapping Community-engaged research |
| title | Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study |
| title_full | Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study |
| title_fullStr | Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study |
| title_full_unstemmed | Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study |
| title_short | Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study |
| title_sort | factors influencing evidence based cardiovascular disease prevention programming in rural african american communities a community engaged concept mapping study |
| topic | Cardiovascular disease Evidence-based programs Implementation Group concept mapping Community-engaged research |
| url | https://doi.org/10.1186/s43058-024-00692-8 |
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