Be Heart Smart: Addressing the High Burden of Cardiovascular Disease Among African-American Women

Feb 5, 2014, 8:28 AM, Posted by Nadia Winston

Nadia Winston, MSPH, is a graduate student at the University of Illinois at Chicago, School of Nursing, pursuing dual nurse practitioner studies in family practice and occupational health. She has a master of science in public health degree from Meharry Medical College and is a former scholar with the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College. This post is part of the “Health Care in 2014” series.

Cardiovascular disease is the number one killer of African American women. It has become imperative for the nation to take back the reins of its health status and educate the public about this threat. The statistics are alarming. Black women are twice as likely to suffer from cardiovascular disease as women of other ethnicities. And according to the American Heart Association, cardiovascular disease kills nearly 50,000 African-American women annually. The reason for this disparity can be attributed to a lack of health knowledge, being overweight or obese, and lack of physical activity. Early intervention and action has been identified as the key to reducing this population’s risk of mortality from cardiovascular disease and related diagnoses.

Addressing and raising awareness of the health risks associated with cardiovascular diseases for African American women has been quite challenging. Recognizing this issue, Vanessa Jones Briscoe, PhD, MSN, then a Health Policy Associate at the Center for Health Policy at Meharry Medical College, developed and implemented a culturally appropriate health education program to educate minority populations about unhealthy lifestyles. It is called the “Be Heart Smart” program.

Based in Tennessee, “Be Heart Smart” arose out of Briscoe’s desire to address health inequities and her experience witnessing the multitudes of African American women suffering in silence from cardiovascular disease. “They had no hope, because they lacked the appropriate knowledge to treat the disease,” she says. “I knew that something had to be done.” Sharing in Briscoe’s interest in decreasing cardiovascular disease in African American women, I joined forces with her in order to promote the “Be Heart Smart” agenda. As a health care professional and rising clinician, I can identify with Briscoe’s passion to help educate African American women about this pressing issue. I have witnessed within my own community and family how cardiovascular disease is inappropriately handled due to lack of health knowledge.

Funded by an educational grant from Boston Scientific, the implementation of the “Be Heart Smart” program was conducted in Tennessee. The program was held between June 2012 and December 2012. Forty-seven African American women participated in the educational health program. Participants were enrolled at designated community sites and participated in study activities, which included a heart disease education course and a line-dancing course for physical activity engagement.

The “Be Heart Smart” program utilized the American Diabetes Association’s diabetes education tool, “Choose to Live, Sisters Strong Together,” sponsored by the African American Initiatives. This tool has been specifically tailored to African American women to encourage them to take charge of their health. Led by a certified diabetes educator, the health education tool was delivered as a workshop to participants of the “Be Heart Smart” program. We found that by delivering the tools in workshop form, participants of the program felt open to discuss their physical and emotional health.

Physical screenings were performed at Month 1 (Baseline), Month 3, and Month 6. Measurements from the physical screening included: height, weight, waist circumference, body mass index (BMI), blood pressure, and blood analysis. The data gathered at these intervals were utilized to identify participants’ health risks and suggest an appropriate health prevention program. According to preliminary health survey reports, more than 30 percent were pre-hypertensive, pre-diabetic, and were obese. Over the 6-month time period, study results showed that glucose levels decreased. However, the mean BMI did not change and no significant changes were witnessed in blood pressure and lipid values. Mean health education knowledge increased slightly after the intervention. Weight loss trended down for a small group of the participants, but that was not statistically significant when analyzed. This could be attributed to the small sample size of participants in the study.

Our initial experience with the “Be Heart Smart” program appears to be promising based upon initial program completion rates and trends toward improved metric of health for this high-risk population. The culturally sensitive, health education program developed for African American women to help increase their awareness of cardiovascular disease warrants further refinement and evaluation. Future outcomes of the study will contribute to the literature on community-based intervention for this population; and inform approaches that improve heart disease, diabetes, and obesity awareness and reduce these risks in African American women.

Plans to expand “Be Heart Smart” are underway. In 2013, the non-profit organization AKTIHFA was created.  It stands for “Acquiring Knowledge to Improve Health for All.” The organization aims to develop and deliver effective programs that teach people and their communities how to improve health for all. In the summer of 2014, AKTIHFA will host a summer research internship program for high school juniors and seniors interested in careers in the health professions. Students will be paired with mentors and develop community-based health projects. 

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.