Progress Report #1 GROUP PROJECT

Overview:

Topic: Coronary heart disease prevention in middle aged African American professional men who travel and frequently eat out at fast casual restaurants (you were asked to give this talk at an area business employing a professional work force during their monthly business meeting)

Target Audience: Middle Aged African American Men

Needs Assessment:

Health Needs: Disease Prevalence and Mortality

African American men suffer from the burden of preventable morbidity and mortality compared to other races and genders. The National Center for Health Statistics states that black males have the highest death rate of any group, totaling at 921 deaths per 100,0001. This number sets African American men apart from any other group because at this rate, their mortality rate is 60% higher than whtie males and 90% higher than the overall death rate1. Not only this, but even though the life expectancy for black males has increased 1.1 years, it is still a little over 7 years behind that of white meals and a little over 9 years behind that of the overall life expectancy1. Some of the reasons concluded for these low rates include the high death rate from preventable diseases, such as heart diseases, as well as accidents and suicide in young African American men. The idea that suicide has such a prevelance in the deaths of African American men highlights how emotional wellness plays such a big factor in the overall and nutritional wellbeing of humans1. Because of their racial and gender identities, which heightens the need for masculinity, African American men’s emotional wellness is not always a priority, both by themselves or by others. In another study, it was found that men who attained a four-year degree or above show higher levels of physical wellness than men with less than a highschool diploma2. Similarly, the same rates were among men studied for emotional wellness. Educational level as well as salary had the most major influences on participants physical and emotional wellbeing2. However, it was found that those who made more annually seemed to struggle more with emotional wellbeing2. This can be an important factor to look at seeing as our audience is an African American Businessman, which means that emotional wellbeing can be a very influential factor on his needs [considering he is more wealthy]2. As for disabilities, 1 in 4 African American have a disability, and 11% of African Americans report having a disability2. Disabilities such as arthritis, CVD, depression and diabetes can be some of the disabilities looked at for our audience.

Resource Needs: Income and Lifestyle Factor

Due to being busy businessmen who travel frequently it would make sense that this specific audience may not have time to make food for themselves and depending how much they are making, it may also be true that economically, choosing healthier, more expensive food may not be a viable option. Compared to white men, black men were only paid 69.7 cents to the dollar a white man would make3. Although the study was about childhood obesity and lower income being more connected in black children than white children, this can potentially carry into adulthood since this can set children up with habits with food with money but also how they prefer to eat and may not enjoy fruits or vegetables4. Although they could potentially have personal chefs depending on their income this may be difficult if they are consistently traveling.

Educational Need: Knowledge

Middle-aged African American professional men would benefit from being educated on the importance of healthy eating. Since they are traveling a lot and do not have time to cook healthy meals an educational class on cooking and/or nutrition would be very beneficial. Although the use of education is not the only resource they need it can be very helpful. A study found that increased education levels leads to increased health knowledge, improved health behaviors, improved employment opportunities, and a positive influence on psychological factors5. Improved employment opportunities are crucial because some jobs offer benefits like health care which in turn greatly improves a person's health. This same study also found a disparity in educational levels between different races. A higher percentage of white American males have a college degree or higher than African American males5. There is a need for education within the African American community. Higher education rates can result in better health outcomes for communities.

Developmental Needs: Life Stage

The frequency of eating out at fast casual restaurants impacting the risk of developing chronic diseases can be easily ignored as professionals are often on business trips. Obesity has increased in the cases particularly among African American males which nearly 40 percent of African American men ages 40 and older are obese6. Individuals with the potential of being obese may also in risk of having higher levels of hypertension, diabetes mellitus, total cholesterol, and triglyceride and lower level of high-density lipoprotein cholesterol than the nonobese7. Low levels of high-density lipoprotein is associated with coronary heart disease8. A lot of this has to do with genetics. As for looking for more closely into the life stages of African Americans, it has been found that upbringing and exposure has a lot to do with health choices9. In general African Americans do not find healthier foods as tasteful, or fulfilling9. This could also tie into the educational needs, which show that African American men have lower educational levels5. A lower education level is a result of disproportionate treatment, lack of oppurtunity, and different upbringing which can be a target to understand why African Americans are having a harder time making healthier choices, even when they are at a higher risk for diseases like CHD.

Affiliated Theory or Model: Health Belief Model

Roles of each member:

Meeting coordinator - Sarah, Lily

Info Organizer - Lily

Work Submitter - Sarah, Charles, Lily

Discussion Mediator - Charles

Project Timeline:

3/11- We met on Zoom and discussed the Lesson Plan

3/14- We turned in the Lesson Plan

3/14- Meeting with Bernard

3/15- Met on zoom to further discuss the scope of our target audience

3/28- Meeting with Professor Ford

3/29- Worked on Goals and Objectives on zoom

3/29- Turned in Goals and Objectives

3/30- Group Member Evaluations Midpoint

4/3- Met on Zoom and completed Progress Report #1

Goals And Objectives:

Goal: Middle Aged African American businessmen will learn how to identify and incorporate healthy meals while traveling for business and understand how to avoid the risk factors of coronary heart disease.

Objective 1: At the end of the lesson, at least 50% of the businessmen will be able to identify 2 risk factors of coronary heart disease.

Objective 2: At the end of the lesson, 60% of the businessmen will be willing to incorporate physical activity in their daily life.

Objective 3: At the end of the lesson, 70% of the businessmen will be willing to replace at least one of their fast food options with a healthy alternative.

We will be prioritizing health needs and resource needs. Health needs need to be prioritized because for our specific target audience, African American males, mortality rates are significantly higher. With the added issue of coronary heart disease, we should be focusing on health needs so that our audience can learn how to best take care of themselves. Resource needs are also very important to take into consideration because our target audience is categorized as traveling business men. This means that our audience will most likely not be able to cook for themselves often, and are also categorized as eating at fast food restaurants. If we focus on resource needs, we can teach our audience how to adapt better to eating on the go as well as how to avoid eating fast food and find better alternatives at the same price and convenience.

Article Summaries:

Article #1: The Health of African American Men

African American men have a mortality rate that is significantly higher than many other races1. This article can be helpful in developing the health needs of our target audience because it not only highlights the urgency of protecting the health of African American men, but why African American men have a higher mortality rate. This is helpful because knowing the root causes of these problems will allow our group to target these causes and create a lesson plan that will cater to our target audience the best.

Article #2: Education, genetic ancestry, and blood pressure in African Americans and Whites

This article discussed the correlation between the education levels and blood pressure across African American and White populations. They found that the relationship between education and blood pressure was stronger among African Americans5. The populations who showed the worst blood pressure readings were the African Americans who had less than a highschool diploma5. The white population who also had less than a highschool diploma showed better blood pressure readings5. This article highlights the educational aspect of our needs assessment. African Americans who have low education are at a higher risk for health problems than white populations.

Article #3: Male Gender Role Strain as a Barrier to African American Men’s Physical Activity.

In this article it was discussed how African American men tend to focus on their aspect of being a “provider”, and other aspects of being important or a leader rather than important health aspects such as participating in physical exercise6. This study used 105 middle-aged African American men and looked into aspects that could affect the amount of exercise they were doing. This showed how jobs, families, and other commitments may keep them too busy from participating in exercise. Also, since exercise was more “independent” they would lean more towards focusing on their family, working, and other priorities, as well as the amount of time, effort, and energy the men were putting into “providing”. This need for being the provider kept them from being able to put more into exercise, and overall health behaviors6.

Health Belief Model (HBM):

We are using the health belief model because it fits our project's goal of preventing coronary heart disease. We will use the construct's perceived benefits and perceived severity to persuade these businessmen to change their behavior. We will also use the modifying factors of gender and ethnicity to understand the problem and the audience. We chose this particular theory because this is an explanatory theory and we are trying to explain to the businessman why it’s important to eat a balanced diet.

The Health Belief Model can be a successful intervention model for African American businessmen because it has been proved that the HBM model is successful in understanding, addressing and intervening11. Understanding is important because if the audience is not properly researched and understood, the lesson plan will not resonate with the audience and change will evidently not be made11. Addressing is the art of understanding the problems the target audience faces and finding what the proper targets are to ensure proper intervention. Intervening is the actual actions put in to educate and motion for change in the target audience, all while remaining unbiased and using activities that are shaped for the target audience11.

Picture References:

1. bit24. Best Foods for healthy Heart on a wooden background. Adobe Stock. Accessed April 13, 2022.

2. Elnariz. Headshot of successful smiling cheerful african american businessman executive stylish company leader. Adobe Stock. Accessed April 4, 2022.

References:

1. Rich JA. The Health of African American Men. Ann Am Acad Political Soc Sci. 200;569(1). https://doi.org/10.1177/000271620056900111.

2. McNeish R, Simmons C, Watson J, et al. Perceptions of emotional and physical wellness among African American men as predictors of perceived overall health. Ethn Health. 2021;26(4). https://doi.org/10.1080/13557858.2018.1530738.

3. Gould E, Jones J, Mokhiber Z. Black workers have made no progress in closing earnings gaps with white men since 2000. Econ Policy Inst. 2018. https://www.epi.org/blog/black-workers-have-made-no-progress-in-closing-earnings-gaps-with-white-men-since-2000/.

4. Assari S. Family income reduces risk of obesity for white but not black children. Obes Met Dys Chi. 2018;5(6). https://doi.org/10.3390/children5060073.

5. Non AL, Gravlee CC, Mulligan CJ. Education, Genetic Ancestry, and Blood Pressure in African Americans and Whites. Amer J Public Health. 2012;102(1559). https://doi.org/10.2105/AJPH.2011.300448.

6. Griffith DM, Gunter K, Allen JO. Male Gender Role Strain as a Barrier to African American Men’s Physical Activity. Health Educ Behav. 2011;38(5). https://doi:10.1177/1090198110383660.

7. Shakiba M, Mansournia MA, Salari A, et al. Accounting for Time-Varying Confounding in the Relationship Between Obesity and Coronary Heart Disease: Analysis with G-Estimation: The ARIC Study. Amer J Epi. 2017;187(6). https://doi:10.1093/aje/kwx360.

8. Gotto AM, Brinton EA. Assessing low levels of high-density lipoprotein cholesterol as a risk factor in coronary heart disease: A working group report and update. 2004;43(5). https://doi:10.1016/j.jacc.2003.08.061.

9. Newton RL, Griffith DM, Kearney WB, et al. A systematic review of weight loss, physical activity and dietary interventions involving African American men. Obes Rev. 2014;54(15). https://doi.org/10.1111/obr.12209.

10. Rollins L, Sy A, Crowell N, et al. Learning and Action in Community Health: Using the Health Belief Model to Assess and Educate African American Community Residents about Participation in Clinical Research. Int J Res Public Health. 2018;15(9). https://doi.org/10.3390/ijerph15091862.