Abstract 9442: Increasing Patient Activation Among Black American Men in a Community-Based Lifestyle Intervention Pilot: Black Impact

Abstract

Introduction: Life’s simple 7 (LS7) is a seven-metric framework from which cardiovascular health can be measured. Black Americans have the lowest attainment of LS7 among all communities. This may be in part related to patient activation or “having the capability and the willingness to take on the role of managing one’s own health and health care”. Patients with lower patient activation scores on the Patient Activation Measure tool (PAM) are more likely to develop and suffer from chronic diseases like hypertension and stroke. Black Americans report lower patient activation as compared to Non-Hispanic Whites, and lower medication adherence. Here, we discuss changes in patient activation during a 24-week community-based, lifestyle intervention focused on improving cardiovascular health in Black American men. Methods: We recruited 74 Black men with less than 4 of 7 LS7 metrics in the “ideal” range to participate in Black Impact, a community-based lifestyle intervention adapted from the AHA’s Check, Change, Control Program and Diabetes Prevention Program. Participants met weekly in groups of 8-25 for 24 weeks, completing group-based physical activities and health education sessions. Biometric screenings and self-report surveys (including the PAM 10-item questionnaire) were administered at baseline, 12, and 24 weeks. Changes in PAM scores at 12 and 24 weeks were calculated using a linear mixed-effects model with random intercepts. Results: The mean baseline PAM score of participants, when adjusted for age, education, and income, was 64.68 (95% CI: 60.51, 68.85). At week 12, the PAM score increased by an average of 4.36 (95% CI: 1.09, 7.63; p = 0.01). At week 24, the increase from baseline was 8.22 (95% CI: 5.06, 11.38; p < 0.001). Increases in PAM were non-significantly associated with increases in LS7 over the 24 weeks (p= 0.346) Conclusions: In Black Impact, PAM scores increased substantially at 12 and 24 weeks. The 8-point PAM increase at 24 weeks is equivalent to a 16% reduction in the likelihood of hospitalizations and a 16% increase in medication adherence. These findings suggest community-based lifestyle interventions focused on increasing cardiovascular health may be a key strategy in advancing equity in patient activation.