Physical Function in Midlife and Older Adults From an African American Church-Based Health Screening.

INTRODUCTION: Limitations in physical function are predictive of adverse health outcomes, and screening has been recommended in clinical settings for older adults. Rarely assessed in community-based settings, physical function could provide insight for tailoring health-related community-based programs and raise awareness about this important aspect of health. This cross-sectional study seeks to demonstrate the feasibility of integrating physical function assessments into health screenings in African American churches in Chicago, Illinois, through a large health partnership and to determine the prevalence and correlates of physical function limitations among midlife (aged 40-59 years) and late-life (aged ≥60 years) participants. METHODS: Screenings were held in 7 churches in Spring 2018. Physical function was assessed using the Short Physical Performance Battery. Demographics, medical history, health status, and health behaviors were assessed. Age-stratified logistic regression identified independent associations with physical function limitations (Score ≤9) among midlife and late-life participants (data were analyzed in 2018-2019). RESULTS: Among 731 participants (median age=57 [IQR=51-65] years, 58% women, 97% African American), 25% of midlife and 56% of late-life participants had physical function limitations. For midlife participants, fair/poor health (OR=1.83, 95% CI=1.10, 3.05), stroke/neurologic conditions (OR=2.42, 95% CI=1.07, 5.46), and arthritis (OR=2.25, 95% CI=1.32, 3.81) were associated with higher odds of limitations. Fair/poor health (OR=1.97, 95% CI=1.11, 3.50) and stroke/neurologic conditions (OR=7.85, 95% CI=2.22, 27.74) were related to limitations among late-life participants. CONCLUSIONS: Physical function screening was successfully implemented into this large-scale church-based health screening program. Physical function limitations were prevalent, particularly at midlife; this information will be used to guide future programs.

A Small-Changes Weight Loss Programfor African-American Church Members.

OBJECTIVE: To test whether a previously tested, small-changes weight loss program could be translated for use in African American churches. METHODS: The program consisted of 12 group sessions held weekly at a partner church. Key intervention messages were disseminated via Facebook. A single-arm pretest-posttest evaluation included assessments at baseline, program completion (3-month), and after three months with no contact (6-month). RESULTS: Participants (N = 17; 16 women, age 57.5±12.1 years, body mass index 36.5 kg/m2±5.4, hemoglobin A1c 6.3±0.5, blood pressure 132±14/82±7) attended an average of 77% (mdn=9) of treatment sessions and 94% and 100% completed the 3- and 6-month assessment visits. All participants reported they were "somewhat" or "very satisfied" with the program. There was minimal interaction with Facebook with an average of 0.5 comments and 3.9 reactions per post. Three- and six-month reductions (all p's≤.01) were observed for weight (mdn=-2.7 kg; mdn=-2.6 kg), waist circumference (mdn=-3.8cm; mdn=-5.1cm), and hemoglobin A1c (mdn=-0.5; mdn=-0.3). At 3-months, there were significant reductions in systolic (mdn=-10.7 mmHg) and diastolic blood pressure (mdn=-8.0) but not at 6 months. CONCLUSIONS: This study suggests that a faith-based, faith-placed intervention utilizing a small-changes approach in African American churches may achieve sustained weight loss in parishioners with obesity.

Sleep-related attitudes, beliefs, and practices among an urban-dwelling African American community: a qualitative study.

OBJECTIVES: Short sleep duration and poor sleep quality are more prevalent among African Americans (AAs) and may be a modifiable risk factor for cardiometabolic disorders. However, research is limited about sleep-related attitudes, beliefs, and practices among AAs. Our objective was to evaluate these practices and beliefs surrounding sleep among urban-dwelling AAs. DESIGN: Qualitative study comprised of five 90-minute focus groups using a semistructured interview guide. SETTING: Five churches located on the west side of Chicago. PARTICIPANTS: Adults (N = 43) ages 25-75 years. MEASUREMENTS: Transcripts were voice recorded, transcribed, and then coded for content analysis using NVivo 12 Pro to capture themes in the discussions. RESULTS: Most participants (86%) reported sleeping less than the recommended 7 or more hours. The discrepancy between actual and desired sleep duration was nearly 3 hours per night. Participants reported that sleep is essential for mental and physical health. Napping and consuming caffeine were frequently reported techniques for coping with lack of sleep. Noise, physical discomfort, and stress were reported as barriers to sleep, and participants reported using TV and other electronics to cope with racing thoughts or worry. Many participants were diagnosed with or knew someone with obstructive sleep apnea, but few participants had been diagnosed with insomnia or were aware of nonpharmacologic insomnia treatments. CONCLUSION: A cycle of stress/disruptive environment, stress, rumination at night, and coping by use of electronics and daytime napping may perpetuate sleep disparities in this community. Results suggest that sleep-related interventions should include stress reduction and environmental improvements in addition to the typical sleep hygiene-related behavioral recommendations.