Resource-limited communities in Washington, D.C., have high rates of obesity-related cardiovascular disease in addition to inadequate physical activity (PA) facilities and limited internet access. Engaging community members in the design and implementation of studies to address these health disparities is essential to the success of community-based PA interventions. We used qualitative and quantitative methods to evaluate the feasibility and acceptability of PA-monitoring wristbands and web-based technology by predominantly African-American, church-based populations in resource-limited Washington, D.C., neighborhoods. To address cardiovascular health in at-risk populations in Washington, D.C., we joined community leaders to establish a community advisory board, the D.C. Cardiovascular Health and Obesity Collaborative (D.C. CHOC). Our first initiative, the Washington, D.C., Cardiovascular Health and Needs Assessment, intends to evaluate cardiovascular health, social determinants of health and PA-monitoring technologies. At the recommendation of D.C. CHOC members, we conducted a focus group and piloted the proposed PA-monitoring system with community members representing churches that would be targeted by the Cardiovascular Health and Needs Assessment. Participants (n=8) agreed to wear a PA-monitoring wristband for two weeks and to log cardiovascular health factors on a secure online account. Wristbands collected accelerometer-based data that participants uploaded to a wireless hub at their church. Participants agreed to return after two weeks to participate in a moderated focus group to share experiences using this technology. Feasibility was measured by online account usage, wristband utilization and objective PA data. Acceptability was evaluated through thematic analysis of verbatim focus group transcripts. Study participants (5 males, 3 females) were African-American and aged 28-70 years. Participant wristbands recorded data on 10.1 +/- 1.6 days. Two participants logged cardiovascular health factors on the website. Focus group transcripts revealed that participants felt positively about incorporating the device into their church-based populations given improvements were made to device training, hub accessibility, and device feedback. PA-monitoring wristbands for objectively measuring PA appear to be a feasible and acceptable technology in Washington, D.C., resource-limited communities. User preferences include immediate device feedback, hands-on device training, explicit instructions, improved central hub accessibility, and designation of a church member as a trained point-of-contact. When implementing technology-based interventions in resource-limited communities, engaging the targeted community may aid in early identification of issues, suggestions and preferences. Among women in the Washington, D.C. CV Health and Needs Assessment (99% African American mean age=59 (12) years), 90% had a body mass index (BMI) categorized as overweight or obese, with 30% having Class-I obesity, 19% having Class-II obesity, and 17% having Class-III obesity. Across weight classes, PA decreased (p<0.05) and self-reported sedentary time increased (p<0.05). Although diastolic blood pressure and fasting blood glucose significantly increased across weight categories among women, blood pressure, cholesterol, and glucose were relatively well-controlled with mean values consistent with ideal or intermediate levels of the American Heart Associations cardiovascular health cut-points. PA-monitoring system compliance remained above 60% for the 30-day study period among women participating in the study, with similar compliance among women with obesity over the study period. Therefore, deployment of mHealth technology with CBPR strategies can help target PA for improving cardiovascular health among African American women in resource-limited communities.
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