Hawkins Jaclynn
School of Social Work, Department of Learning Health Sciences (DLHS), Medical School, University of Michigan, 1080 S University Ave, Ann Arbor, MI, 48109, USA.
Curr Diab Rep. 2025 Jul 8;25(1):41. doi: 10.1007/s11892-025-01597-z.
Black men in the United States experience a disproportionate burden of cardiometabolic diseases, including type 2 diabetes (T2DM), hypertension, and cardiovascular disease (CVD). Despite these disparities, existing interventions often fail to address the shared risk factors, structural determinants, and implementation barriers that impact engagement and sustainability. This review applies implementation science frameworks to evaluate strategies for improving cardiometabolic interventions tailored to Black men.
Community-based interventions, culturally tailored health education programs, and peer-led models have demonstrated success in improving cardiometabolic outcomes for Black men. However, challenges such as medical mistrust, underrepresentation in research, and systemic barriers continue to limit their reach and sustainability. The Consolidated Framework for Implementation Research (CFIR) identifies multi-level barriers and facilitators, the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework assesses intervention impact, and the Framework for Reporting Adaptations and Modifications for Evidence-Based Interventions (FRAME-IS) highlights equity-driven adaptations. Applying implementation science frameworks provides structured insights into optimizing interventions for Black men by addressing barriers across patient, provider, and system levels. Key facilitators include culturally relevant adaptations, an inclusive healthcare workforce, and trusted community partnerships. Future research should integrate equity-focused implementation strategies to improve adoption, engagement, and long-term sustainability of cardiometabolic interventions for Black men.
美国黑人男性承受着不成比例的心脏代谢疾病负担,包括2型糖尿病(T2DM)、高血压和心血管疾病(CVD)。尽管存在这些差异,但现有的干预措施往往未能解决影响参与度和可持续性的共同风险因素、结构决定因素及实施障碍。本综述应用实施科学框架来评估针对黑人男性量身定制的改善心脏代谢干预措施的策略。
基于社区的干预措施、文化上量身定制的健康教育项目以及同伴主导的模式已证明在改善黑人男性的心脏代谢结局方面取得了成功。然而,诸如医疗不信任、在研究中的代表性不足以及系统性障碍等挑战继续限制着它们的覆盖范围和可持续性。实施研究综合框架(CFIR)确定了多层次的障碍和促进因素,可及性、有效性、采用、实施和维持(RE-AIM)框架评估干预影响,循证干预措施的调整和修改报告框架(FRAME-IS)突出了以公平为导向的调整。应用实施科学框架通过解决患者、提供者和系统层面的障碍,为优化针对黑人男性的干预措施提供了结构化的见解。关键促进因素包括与文化相关的调整、包容性的医疗保健劳动力以及值得信赖的社区伙伴关系。未来的研究应整合以公平为重点的实施策略,以提高针对黑人男性的心脏代谢干预措施的采用率、参与度和长期可持续性。