Jennifer A. Garner

Background: Lower attainment of cardiovascular health (CVH), indicated by lower scores on the American Heart Association's Life's Essential 8 metrics, is a major contributor to Black men having the shortest life expectancy of any nonindigenous race/sex group. Evidence‐based community interventions to improve CVH in Black men are sparse; thus, an academic–community–government–industry partnership was developed to cocreate and test a 24‐week CVH intervention for Black men, Black Impact, in line with best practices for community‐based participatory research. Methods and Results: The Black Impact intervention is delivered by health coaches, fitness trainers, and community health workers and emphasizes weekly physical activity, health education, and addressing social needs. Together, academic–community–government–industry partners will conduct a randomized, waitlist‐controlled trial among 340 Black men with suboptimal CVH to determine intervention: (1) efficacy on CVH and psychosocial stress; (2) effect on individual and interpersonal outcomes; (3) effect on biological mechanisms responsive to psychosocial stress; and (4) organizational contexts and resources necessary for sustainability of the academic–community–government–industry partnership. An intervention working group of academic–community–government–industry partner representatives will guide implementation and evaluation. Upon trial completion, findings (eg, change in CVH at 24 weeks [primary], change in perceived stress at 24 weeks [coprimary], biological mechanisms, psychosocial process mediators [stress, social and interpersonal processes]) will be disseminated in scientific and lay settings. Conclusions: Robust clinical trials are needed to test novel interventions focused on CVH equity. Black Impact will determine intervention efficacy, evaluate biological and psychosocial mediators of impact, and lay a framework for sustainability and scalability. Registration: URL: https://clinicaltrials.gov/ ; Unique Identifier: NCT06055036.

The Nutrition Care Process (NCP) is a systematic framework for providing nutrition care and a cornerstone of dietetics practice. Dietetics education relies on development of skills to achieve competence and demonstrate readiness for practice. The relationship between development of fundamental skills and self-efficacy among dietetics students preparing for clinical practice remains unclear. The purpose of this study was to examine the development of dietetics students’ skills in NCP documentation and their self-efficacy in performing the skills over one academic year. Student nutrition notes (n=120 notes, n=30 students) from standardized patient encounters were evaluated for quality using a validated tool: NCP-QUEST at four timepoints during the academic year. An optional self-efficacy questionnaire was completed by students (n=24) at three timepoints. Mean (± standard deviation) and repeated measures mixed-effects linear regression were used to describe the results. NCP-QUEST scores improved significantly over the course of the program (p<0.0001). Students’ self-efficacy in the NCP also significantly improved over time (p<0.0022), even when controlled for NCP-QUEST scores (p<0.006). Students demonstrated significant gains in skills and self-efficacy related to the NCP as they progressed through the dietetics curriculum. Targeted efforts to improve clinical decision-making and documentation may further support development of students’ self-efficacy.

Background: Higher scores for the American Heart Association Life's Essential 8 (LE8) metrics, blood pressure, cholesterol, glucose, body mass index, physical activity, smoking, sleep, and diet, are associated with lower risk of chronic disease. Socioeconomic status (SES; employment, insurance, education, and income) is associated with LE8 scores, but there is limited understanding of potential differences by sex. This analysis quantifies the association of SES with LE8 for each sex, within Hispanic Americans, non‐Hispanic Asian Americans, non‐Hispanic Black Americans, and non‐Hispanic White Americans. Methods and Results: Using cross‐sectional data from the National Health and Nutrition Examination Survey, years 2011 to 2018, LE8 scores were calculated (range, 0–100). Age‐adjusted linear regression quantified the association of SES with LE8 score. The interaction of sex with SES in the association with LE8 score was assessed in each racial and ethnic group. The US population representatively weighted sample (13 529 observations) was aged ≥20 years (median, 48 years). The association of education and income with LE8 scores was higher in women compared with men for non‐Hispanic Black Americans and non‐Hispanic White Americans ( P for all interactions <0.05). Among non‐Hispanic Asian Americans and Hispanic Americans, the association of SES with LE8 was not different between men and women, and women had greater LE8 scores than men at all SES levels (eg, high school or less, some college, and college degree or more). Conclusions: The factors that explain the sex differences among non‐Hispanic Black Americans and non‐Hispanic White Americans, but not non‐Hispanic Asian Americans and Hispanic Americans, are critical areas for further research to advance cardiovascular health equity.

As requirements for entry-level dietitians advance to the master’s degree level, the Accreditation Council for Education in Nutrition and Dietetics has published a Future Education Model (FEM). At present, FEM utilizes Competency-Based Education (CBE) for optional program implementation at early adopter demonstration sites. A limited number of CBE programs exist within the field of dietetics, and there is little published literature on its use in this arena. The present study leverages focus groups with students and interviews with faculty and preceptors to evaluate use of a novel CBE program in dietetics and explore factors that facilitate or hinder implementation of such program. A series of focus groups (n=5) were conducted with FEM-engaged students over the course of the 2021-2022 academic year. Faculty (n=9) and preceptors (n=8) involved with training students in a FEM program were invited to participate in in-depth interviews to complement the student perception. Qualitative data collection was conducted and recorded with videotelephony software, and transcribed verbatim prior to analysis. Semi-structured focus group and interview guides and template analysis were used for data collection and analysis. Coding was conducted independently and compared by two trained reviewers. Facilitators of implementing a CBE program in dietetics included prior educational and work experience, support of coworkers, advancement of the profession, and efficient programmatic structure. Barriers included a lack of preceptor training, difficulty assessing competence, and the resource intensiveness of the program. CBE programs in dietetics should consider extra administrative resources, training of preceptors, and a programmatic-level assessment plan when implementing such programs.