Dr. LaPrincess Brewer, a cardiologist at Mayo Clinic in Rochester, grew up in Charlotte, NC, attending a Black church. She recalls, “I saw so many congregation members, who were like family to me, passing away from preventable chronic diseases, heart attacks and stroke. I carried these heartbreaks and memories with me throughout my training in medical school. Pursuing a career in cardiology would allow me to reach members of the population that are disproportionately affected.”
The disparities in cardiovascular health are “stark and striking,” Brewer says. Because the Black community is impacted at a rate significantly higher than other racial and ethnic groups and the general population, she began developing a program dedicated to encouraging healthy behavioral changes and supporting healthier lifestyles.
Brewer started a community-based project called FAITH! (Fostering African-American Improvement in Total Health) Program, to develop culturally tailored interventions for Black residents. Recently, her team developed a smartphone FAITH! App, which includes group support through social networking and educational modules on heart health. Members of Black church groups were part of the design and implementation of research questions. “With that buy-in, it helps with the actual use of interventions by the intended audience,” says Brewer. “It is community designed and supported.”
The goal of the 10-week program is to track improvement in heart health, using seven steps to reduce risk, as identified by the American Heart Association: quit smoking, maintain a healthy weight, eat nutritious foods, get regular physical activity, control blood pressure, and maintain normal glucose and cholesterol levels. The program checks participants before and after the program to follow their progress. Some choose to track and monitor one risk factor and behavioral change at a time.
Results published in 2019 from the pilot study found that the FAITH! App and its social support within faith communities made a difference in the heart health of the study participants. The tool encouraged users to increase their daily consumption of fruits and vegetables and physical activity. Most who had “poor” health at the start moved to “good” and “ideal” ranges after participating in the program.
Brewer focused the study on the Black church because it is the spiritual home of so many. “It is a trusted institution in the community. Partnering with Black churches — trusted for information — has been ideal by integrating it with their health ministries and propagating it through the community.
Black women have the highest cardiovascular mortality rate of all women. Only nine percent of Black women meet at least five of the seven heart-healthy goals outlined by the American Heart Association compared to 24 percent of white women.
“This is not just related to health and risk factors,” notes Brewer. “It is also social determinants: food insecurity, lack of recreational activities or safe nearby parks, lack of educational and income opportunities. Basically, they have so many barriers preventing them from living healthy lives.”
It is in the faith community that people’s network of support can make a difference. “They see that other congregation members, the pastor and first lady, are living healthier. They are more likely to be resources to support one another through the journey,” says Brewer. “It is about finding common ground — that we are all going through this together.”
Thanks to funding from the National Institutes of Health and the American Heart Association, Brewer is now conducting a larger randomized, controlled trial with more churches. The program has expanded from Rochester to include the Twin Cities and has grown from five church communities to 16, serving over 90 individuals. Focus groups were held to refine the FAITH! App, which is now being tested in the trial.
The pandemic initially put a hold on program recruitment, but Dr. Brewer and her team eventually were able to triple the number of churches involved through community partners.
Although the program is not available to the general population yet, there is demand for the program and app that Dr. Brewer and Mayo Clinic are working to eventually meet, in partnership with other agencies, non-profits, the American Heart Association, and new faith communities.
As she waits for expansion, Dr. Brewer takes pleasure in her cardiovascular specialty, largely rooted in childhood experiences with her church community. “Cardiovascular medicine is an exciting field. It is multi-dimensional and innovative. It is evolving all the time.”
Dr. LaPrincess Brewer has hosted a town hall series focused on clinicians from minority backgrounds and those who provide care to communities of color. A recording is available.