Can Fitbits be Used to Encourage Health Tracking and Impact Blood Pressure with African-Americans in Barbershop Initiatives?
Presentation
Overview
Overview
Description
Introduction: Health outreach has been implemented in barbershops to help reduce cardiovascular disease (CVD) risk factors and promote healthy behaviors. Barbershops are community centers where community engagement, such as voter registration campaigns, are held, and people discuss politics, sports, food, and relationships. Historical medical mistreatment and racial bias have made many African-Americans hesitant to seek medical care. Providing health promotion activities in an environment where health topics are discussed can help overcome this barrier to care. While this form of health outreach is becoming more common, no studies reported health promotion using wearable activity trackers as part of a barbershop initiative. African-Americans have higher rates of hypertension (HTN) and the highest rate of HTN-related deaths of any racial group in the United States. They often go undiagnosed longer leading to CVD development at a younger age, resulting in increased morbidity and mortality. Physical activity reduces blood pressure (BP), and activity trackers increase activity; thus, wearing an activity tracker may reduce BP. While use of activity trackers is common, low-income African-Americans are least likely to use them. The purpose of this study was to determine technical and wearability issues of activity trackers, and the relationship among wearing patterns, steps, heart rate, sleep, and BP. Methods: Researchers recruited African-American barbers/stylists from three shops participating in a Barbershop Initiative. Participants consented, completed an initial survey, and were assisted with Fitbit setup. Participants wore Fitbits for a month, collecting heart rate, steps, and sleep data. Weekly BPs, wearing patterns, and health questions were collected. At completion, participants completed another survey describing their wearing patterns and perceived health impacts. This study was IRB approved. Results: Out of 14 participants, most were males (71%) with known HTN (64%). Only 29% took antihypertensive medications. Age ranged from 25-75 years (M= 46, SD = 17) and body mass index ranged from 19-46 (M=30, SD =8.5). Preliminary results suggest that users averaged 7876 steps a day with an average resting heart rate of 72 beats per minute. The average change in systolic BP ranged from -22 to +34 (M=2.46), and diastolic BP ranged from -11 to 13 (M=3.6), where negative values indicate worse blood pressure compared to baseline. Nearly 30% (N=4) wore a tracker before but admitted they did not monitor the results. Participants also reported they were exercising more (N=7, 50%), getting more sleep (N=5, 36%), and felt they had better BPs (N=10, 71%). Anecdotally, participants reported that they ‘paid attention’ to the automated reminders and alerts and increased their exercise based on the reminders. Discussion: While there were no statically significant BP changes, participants reported more activity and a focus on improving their risk factors for CVD. While HR and sleep data were captured, it was difficult to correlate without hourly data points. Anecdotally, participants reported they found the intervention helped to improve their health and were willing to encourage others to do the same. Integrating wearables with other Barbershop health promotion activities can promote equitable, sustainable, and culturally sensitive health promotion in this population.
