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A Community e-Health Promotion Program Addressing Oklahoma's Urban Disparities

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? DESCRIPTION (provided by applicant): Health disparities in the African American community persist in spite of numerous public health programs. In Oklahoma, a substantial part of the health gap can be attributed to high rates of unhealthy lifestyle choices. Many Oklahomans in underserved communities underutilize health care, therefore, population-wide health improvement requires approaches that can influence health culture in communities, beyond the regular clinical environment. Computerized Health Risk Assessments (HRAs) have successfully promoted individual behavior change under certain conditions. Enhanced HRAs that combine successful eHealth applications with novel implementation approaches that focus on improved presentation of personal risks, tailored and goal-directed care recommendations, and ongoing health coaching also have the potential to reduce health disparities. However, few eHealth technology studies have been conducted in underserved community settings. Even fewer studies have focused on minority populations facing health disparities. We propose to study an enhanced, web-based HRA that was implemented successfully in primary care, coupled with personalized, goal-directed health planning and facilitated by health coaching. Faith-based settings were selected to maximize our culturally appropriate reach into the community. Working in collaboration with the Faithful, Fit and Strong Health Collaborative, we propose to conduct a staggered, sequential eHealth implementation study, with three groups of congregations. Each group will host a health festival, tailored to meet the needs of their congregation. Adult participants who are interested in the study will be enrolled at the health festival. Participants (N=125) will complete the HRA at the health festival and meet their health coach. Over the next 4 months, participants will set their goals, develop an action plan and evaluate their progress with the health coaches. They will complete a second HRA after 4 months of intensive coaching, followed by a period of gradually tapered coaching. At the end of the community intervention, all participants will complete a satisfaction survey and will be invited to participate in a focus grou to provide feedback about their experiences. The findings from this innovative eHealth technology pilot study will allow us to design a larger and more definitive implementation trial across all member congregations of the faith-based health collaborative. Our study will also facilitate the translation of evidence-based clinical guidelines into practice and create a roadmap for other organizations (other faith communities, schools, senior centers) to engage their communities in technology- empowered prevention and health promotion.
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