Objective:

This study aimed to identify beliefs and behaviors that influence engagement in preventative care for brain and heart disease within an urban community.

Background:

Despite advances in diagnostics and preventative care, the increasing prevalence of brain and heart diseases suggests an opportunity for tailored, community-co-created interventions. Qualitative methodology provides a nuanced understanding of community perceptions of brain and heart health that impact their engagement in preventative care strategies.

Design/Methods:

Residents of a small, diverse, and under-resourced town (population ~13,000; 40% people of color; 50% of households cost-burdened, spending at least 30% of income on housing) participated in eight in-person and virtual focus groups (N=48). The cohort was racially and ethnically diverse with 42% Hispanic and 19% Black participants and had a median age of 58. A semi-structured interview guide was adapted from the Health Stigma and Discrimination Framework. Sessions were recorded, transcribed, and analyzed (by 3 independent coders) using the Framework Method.

Results:

Disease knowledge was a main facilitator that shaped health beliefs and behaviors. Participants were more familiar with the sudden onset and severity associated with a heart attack, which influenced engaging in preventative heart health strategies. In contrast, brain diseases were perceived to cause gradual decline in function. Significant barriers to engaging in preventative care include long clinic wait times, lack of care continuity, high costs, and transportation challenges. Despite these barriers, residents expressed enthusiasm for a community-based health prevention program, emphasizing the importance of trust, convenience, and clear communication for its success.

Conclusions:

Disease knowledge shaped health beliefs and behavior, with heart conditions viewed as a more immediate concern than the perceived gradual progression of brain conditions. While participants supported local prevention efforts, their feedback highlights that future programs must address systemic barriers and be built on the foundations of trust, accessibility, and clear communication to effectively promote preventative care engagement.