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Background: Cardiovascular disease (CVD) is the leading cause of death in the US, and a high prevalence of CVD risks has been observed among Black young adults. Physical activity (PA) and healthy eating (HE) are essential components of lowering CVD risk. Therefore, this study explored the barriers, facilitators, behavior change activities, and health communication channels that can inform the development of a multimedia campaign to promote heart health (i.e., PA and HE) among Black young adults. Between September and November 2019, three focus group discussions (FGDs) with a total of 30 students were conducted at a Historically Black College and University (HBCU) campus within the southern region of the US. Lack of time, body shaming in the gym, and limited HE options on campus were identified as some of the barriers to PA and HE. Knowledge of family health history, Instagram influencers, access to a peer trainer and a dietitian were mentioned as facilitators to PA and HE. Participants suggested various activities to promote heart healthy behaviors, including providing factual health information, teaching healthy food preparation skills, and promoting/creating healthy food options events through social media and print as the communication channels. The focus group findings identified barriers, facilitators, health behavior activity ideas, and the communication channels to encourage PA and HE among Black young adults. The results of this study can be used to inform the development of a multimedia campaign to reduce CVD risk among Black young adults.

OBJECTIVE: This study examined the prevalence of food insecurity (FI) among students attending Historically Black Colleges and Universities (HBCUs) in the Southeastern United States. PARTICIPANTS: Students attending four HBCUs (N=351) completed an anonymous Web-based survey. METHODS: Food insecurity was assessed using the 2-item Hunger Vital Sign Tool. Summary statistics were used to quantify FI experiences. Logistic regression was conducted to determine if student demographic characteristics were significantly associated with FI outcomes. RESULTS: Nearly 3 in 4 students (72.9%) reported some level of FI in the past year. Students representing all levels of postsecondary education reported FI. Meal plan participation did not prevent FI. CONCLUSIONS: Students attending HBCUs experience FI at levels that exceed estimates reported among students attending predominantly White institutions. More work is needed to understand the lived experience of food-insecure HBCU students as a means to ensure institution-level food policies support student academic success and wellbeing.

OBJECTIVE: To understand the distribution of healthy and unhealthy food stores near historically black colleges and universities (HBCUs). PARTICIPANTS AND METHODS: Using ArcGIS Pro’s network analysis tools and ReferenceUSA database, this study characterized the healthy (favorable) and unhealthy (unfavorable) retail food stores within a 5-mile radius, 15-min driving, and 15-min walking distance from each HBCU in North Carolina. RESULTS: Most retail food stores within a 5-mile buffer radius of the 10 HBCUs in North Carolina were unfavorable. Within 15-min driving from each HBCU, 1082 stores (76.0%) were unfavorable food stores, while 332 (24.0%) were favorable. Additionally, there were four favorable and 35 unfavorable retail food stores within the 15-min walking distance of each HBCU. CONCLUSIONS: Favorable food retail stores around HBCUs in North Carolina are limited. Researchers, policy makers, and community stakeholders should work together to improve food environments surrounding HBCUs.

Students at higher institutions of learning are more susceptible to psychosocial problems compared to the general public. These may further be exacerbated by the measures put in place to curb the spread of COVID-19. This mixed methods study examined the factors associated with the psychosocial impact of COVID-19 on students’ financial stability, interpersonal relationships and worries related to achieving academic milestones. Data comprised of a series of closed and open-ended questions collected via Qualtrics from students in the United States and Africa (Central and West). The quantitative data were analyzed using frequency counts, percentages and chi-square, while the qualitative data was analyzed using thematic content analysis. More than 90% of the students resided in the United States, 72.5% were females and 78.4% were undergraduates. Financial hardship was experienced by 26.4% of the students, 55.8% indicated that COVID-19 negatively affected their relationship with friends and over 40% worried over delays in achieving academic milestones. Continent of residence, employment status and financial hardship were significantly associated with the negative impact of COVID-19 on one or more of the students’ relationships and with worries about achieving academic milestones. Qualitative data support the findings that financial hardship contributed to experience of psychological distress by students. It also revealed negative (compromised relationships – broken or fractured relationships and loneliness) and positive (bonding) impact of COVID-19 on interpersonal relationships. School administrators should provide students with resources to access economic relief packages and tele-counseling services to help meet their financial and psychosocial support needs amidst COVID-19. Article visualizations

Background: Due to marginal efforts to increase living donor kidney transplantation, it is unclear whether interventions to improve African Americans’ interest and pursuit of living donation should be tailored to address patients’ exposure to or familiarity with dialysis or transplant settings. Design, Setting, and Participants: We conducted a cross-sectional secondary analysis of baseline data from 3 separate randomized clinical trials among African Americans with varying degrees of experience with dialysis or transplantation (predialysis, on dialysis but not on transplant list, and on transplant wait-list) settings. Methods: Interest in living donation was described using a 0 to 10 scale and pursuit of living donor kidney transplantation by achievement of at least 1 pursuant behavior. In multivariable logistic regression analyses, we assessed the association of knowledge, health literacy, and trust in health care with interest in or pursuit of living donation. Results: Interest among the 3 study cohorts was high (predialysis, 62.9%; dialysis, 67.4%; and transplant wait-list, 74.2%). The dialysis and transplant wait-list study cohorts pursued living donation more readily than those not on dialysis (73%, 92%, and 45%, respectively). Interest and pursuit were not statistically significantly associated with knowledge, health literacy, or the 3 factors reflecting medical mistrust. Conclusion: Interest and pursuit of living donation were greater among study participants with greater exposure to dialysis or transplant settings. Efforts to promote patients’ early interest and pursuit of living donor transplants may consider novel strategies to educate patients with less experience about the benefits of living donor kidney transplantation.

The novel coronavirus disease of 2019 (COVID-19) caused disruptions in the delivery of higher education around the globe. To understand how universities and students are dealing with the sudden change from in-person course delivery to online format, this cross-sectional mixed-method study aimed to (a) ascertain the impact of the COVID-19 pandemic on students’ ability to access online learning; (b) examine how college students adapted to changes in the learning/teaching environment; and (c) explore the students’ perspective on measures that institutions of higher learning could have adopted to ease the abrupt transition to online learning. Results indicate a majority of participants in the US reported access to internet and computers for off-campus learning during the COVID-19 pandemic. A little over half of participants from Africa reported internet access during the COVID-19 pandemic (82% of participants from Nigeria and 66.7% from Ghana). Participants from Cameroon reported the lowest percentage of access to online learning at 59.1%. Participants from Africa reported challenges in adapting to online format due to inadequate access to necessary technological resources such as a reliable internet and computer. Participants identified internal and external resources that could have been adopted to better deal with the transition to online learning. Institutions of higher learning can learn from their initial response to the COVID-19 pandemic to formulate and adjust policies that provide flexibility to effectively transition to online learning while catering to the social, educational and health needs of their students.

PURPOSE OF REVIEW: This study aims to review the evidence on telehealth interventions in rural communities that use primary, secondary, or tertiary strategies for the prevention and management of cardiovascular disease (CVD). RECENT FINDINGS: Studies focused on the reduction of CVD risk factors and mitigation of disease progression among rural populations using telehealth are limited in number but appear to be increasing in the last 5 years. These studies suggest primary-, secondary-, and tertiary-level interventions can impact CVD risk and management. The current review found more studies addressing primary CVD intervention strategies, although the evidence for efficacy at all intervention levels is in the early stages. SUMMARY: Leveraging prevention strategies via telehealth may be an effective vehicle to facilitate improved CVD outcomes among populations traditionally marginalized by geographic location.

PURPOSE OF REVIEW: To review current literature on the use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness information and communication technology infrastructure to improve population level hypertension control. RECENT FINDINGS: There are a limited number of telehealth studies at the different stages of the hypertension control cascade. The small body of evidence suggests several promising innovations. These innovations include the use of interactive text messaging, smartphone applications, and telephone calls demonstrated significant reduction in mean systolic blood pressure and increase in the proportion of hypertensives with blood pressure control. Interventions that included text messaging with educational content had the potential to improve hypertension knowledge and also influence behavioral modification and health-seeking behavior. SUMMARY: There is a need for studies on feasibility, acceptability, and scaling up of telehealth interventions with rigorous study designs.

Many patients struggle to take their prescription medications as prescribed. Multiple interacting factors influence medication nonadherence. The cost of medications, particularly a patient's out-of-pocket cost, spans several of these domains. One proposed option for reducing a patient's out-of-pocket cost involves directly sharing manufacturer rebates with patients to lower their out-of-pocket costs at the pharmacy counter. Rebates are widely used across industries (eg, pharmaceutical manufacturers, tourism taxes, automobile manufacturers) in negotiations between sellers and buyers for a particular product. Medication rebates play an important role in the current US pharmaceutical marketplace. However, rebate contract terms are not publicly reported, so it is difficult for patients to determine if, and how, a rebate is reflected in their out-of-pocket costs. This commentary addresses the role of rebates in the current US healthcare landscape and their relationship with medication adherence.

Cancer is the second leading cause of death in the United States. The objectives of this study were to evaluate cancer prevention programs and participants satisfaction in 51 disparities projects in Florida. This three-phase evaluation included evaluability assessment, process, immediate outcome and impact evaluation using qualitative assessment, case study, document analysis, face-to-face interviews, and survey. In 2006-2007, a total of 3,165, and in 2008-2009, a total of 1,632 individuals participated in the programs respectively. In breast and cervical cancer prevention programs, change of proportion of African-American and Haitian recruitment significantly increased from 2006-2008 to 2007-2009 (-11.3 to 3.4). Among other services, all means of outreach such as mobile vans, faith-based activities, health fairs, and small-group education sessions also increased by 5.3%, 7.9%, 5.5%, and 9.4% respectively. In participants' satisfaction the majority of respondents (N=231) were 35-54 years old (46.7%), non-Hispanic Black (81.7%), female (70.3%), high school and some college educated (58.8%), and with income less than $25,000 (65.5%). The majority of the participants were very satisfied with the program staff's training, cultural sensitivity, language skills, resources, education materials, referral system, and changing behavior (mean score: 4.5-4.7) and with the overall project and the project's role in improving their quality of life.