April 28, 2016

Healthy Hearts Wraps Up Studies

In 2007, IWRI began a partnership with a Northwest tribe to better understand and address cardiovascular disease (CVD) in this Native community. The collaboration resulted first in a research study called Healthy Hearts Across Generations, which collected surveys from 284 randomly selected members from tribal rolls to examine cardiovascular disease risks and examine what coping strategies were most protective. From 2010 to 2012, Healthy Hearts Across Generations also conducted a clinical trial where 135 community parents were randomly assigned to either a cardiovascular disease prevention intervention arm or a comparison arm focusing on increasing family cohesiveness, communication, and connectedness. Both year-long conditions included one month of motivational interviewing counseling followed by personal coach contacts and culturally-grounded family life-skills classes.

Preliminary results from the first study indicated that participants enthusiastically embraced the motivational interviewing component of the program; however, observations of the counselors, survey data, and feedback from participants suggested that depressive symptomatology served as a barrier to achieving CVD preventive behaviors and desired outcomes. In 2012, planning began for the second Healthy Hearts study under the hypothesis that more time and attention to underlying depressive symptomatology may enhance motivation and CVD prevention behaviors.

This wait-list controlled randomized pilot study, called Healthy Hearts, Healthy Minds, was launched in 2013 for Natives in the reservation area whose diabetes/prediabetes put them at greater risk for heart disease. Healthy Hearts, Healthy Minds culturally adapted a successful cognitive-behavioral therapy program to increase medication and treatment adherence for chronic conditions such as diabetes, and used an MI framework to provide one-on-one wellness counseling to 34 participants to promote diabetes self-care. This study came to a close in February 2016.

Local community resources and input from tribal members were used to develop study materials and programs. A community advisory board was convened to review the adapted curriculum, and Native stories and values were incorporated in the weekly lessons. In addition to completing the pilot clinical trial, study staff has been focused on disseminating results from both studies back to the community. Wellness coach Michelle Tiedeman, who has been with Healthy Hearts since 2009, says “It has been an honor to work with the community the past several years. I have had the pleasure to work with some amazing individuals and see them accomplish great things.”

The projects were funded by the National Heart, Lung, and Blood Institute (U01 HL HL087322), and the National Institute on Minority Health and Health Disparities (P60 MD006909).