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Gospel Music: A Catalyst for Retention, Engagement, and Positive Health Outcomes for African Americans in a

Barry Bittman, Indu Poornima, Michael A Smith

Advances in Mind-Body Medicine

|April 12, 2020

Insights

Adding gospel music to lifestyle programs significantly improved retention and engagement for African Americans aiming to reduce cardiovascular risk factors. This faith-based approach enhanced program completion and health outcomes.

Area of Science:

Cardiovascular Health
Health Disparities
Behavioral Science

Background:

Cardiovascular disease mortality is disproportionately high in African Americans, with hypertension as a major risk factor.
Underdiagnosis and undertreatment of hypertension are prevalent in this demographic.
African Americans often prefer health education through church-based, interactive programs.

Purpose of the Study:

To evaluate the impact of a faith-based protocol incorporating musical expression on retention, engagement, and health outcomes in a cardiovascular risk reduction program for African Americans.
To assess the effectiveness of a lifestyle skills program enhanced with gospel music for reducing cardiovascular risk factors.

Main Methods:

A randomized controlled trial was conducted at a Baptist church in Pittsburgh, PA.
Participants were African Americans with at least two cardiovascular risk factors (e.g., hypertension, diabetes, high cholesterol).
The intervention group received standard cardiovascular education plus a gospel music program, while the control group received only standard education over one year.

Main Results:

The intervention group showed a significantly higher retention rate (83.3%) compared to the control group (54.3%).
Participants in the intervention group were 4.21 times more likely to complete the program and attended more sessions.
Both groups achieved sustained systolic blood pressure reductions, but the intervention group showed significant improvements in SF-12 Physical Component Scores.

Conclusions:

Integrating a gospel music program into lifestyle interventions can significantly enhance engagement and retention among African Americans.
This faith-based approach shows promise for improving health outcomes and adherence to lifestyle changes in church settings.
Further research is warranted to explore the broader applicability of this culturally tailored intervention.

Read full analysis

Abstract

Context:

Mortality associated with cardiovascular disease is significantly higher in African Americans compared with people of other ethnicities, with hypertension being the single most significant risk factor in this population. Underdiagnosis and undertreatment of hypertension is common. Although cardiovascular lifestyle education and self-management programs are available for the general public, many African Americans prefer to learn about health-promoting activities through interactive programs led by church ministries.

Objective:

This study examined the influence of adding a faith-based protocol using creative musical expression as a catalyst for improving retention, engagement, and positive health outcomes for African Americans participating in a 1-y, lifestyle skills program for reducing cardiovascular risk factors.

Design:

The study was a randomized, controlled trial.

Setting:

The study occurred at Rodman Street Missionary Baptist Church (Pittsburgh, PA, USA).

Participants:

Participants were African Americans with at least 2 of the following medical conditions: high blood pressure, elevated cholesterol and/or triglycerides, heart attack, angina, stroke, irregular heartbeats, palpitations, shortness of breath, dizziness or fainting, diabetes, and tobacco use.

Intervention:

Intervention and control groups both participated every other week in one 45-min structured cardiovascular risk reduction educational session over the course of 1 year. During alternative weeks, sessions comprised blood pressure checks, coupled with individualized support discussions focused on challenges and identified obstacles to adherence. In addition to the aforementioned sessions, the intervention group participated in a novel gospel music program with weekly, 45-minute vocal and instrumental sessions.

Outcome Measures:

Outcome measures include retention, attendance, systolic and diastolic blood pressures, weight, body mass index, hip measurement, and waist measurement as well as the Short Form-12 (SH-12) Health Survey.

Results:

Subjects in the intervention group demonstrated a statistically significant 83.3% retention rate in the course of 1 year compared with only 54.3% for the control group (cardiovascular lifestyle education sessions alone). Six dropouts were noted in the intervention group in sharp contrast to 16 dropouts in the control group. Participants in the intervention group were 4.21 times more likely to complete the program than the control group. A significant difference was also noted for attendance, which was higher for the intervention group (21.33 sessions for the intervention group vs 17.95 sessions for the control group). Statistically significant systolic blood pressure reductions noted in both groups were sustained 6 mo postprogram conclusion. In addition, a statistically significant pre-between post-between group improvement in SF-12 Physical Component Scores was noted for intervention subjects in sharp contrast with controls who actually demonstrated worsening scores.

Conclusions:

The addition of a gospel music program as a catalyst for increase engagement in a sustainable, healthy lifestyle program warrants further consideration and additional study in African American churches.

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