A culturally and gender responsive stress and chronic disease prevention intervention for low/no-income African American men: The MOCHA moving forward randomized control trial protocol.

Low/no-income, African American men are disproportionally burdened by chronic disease resulting from a complex interplay of systemic, sociocultural, and individual factors. These disparities are related to poverty, racism, gender role strain, high levels of stress, low levels of physical activity, and malnutritious diet. Men of Color Health Awareness (MOCHA) is a community-driven movement to address the physical, mental, social, and spiritual needs of men of color. As part of ongoing programming, the MOCHA Standard intervention consists of a 10-week program including: (1) small group discussions of issues particularly relevant to men of color, (2) classes on health topics focusing on chronic disease control, such as nutrition, obesity, high blood pressure, fitness, and the social determinants of health; and (3) 60-min of moderately intensive aerobic exercise twice a week. While the MOCHA Standard intervention has yielded positive results, feedback from previous participants warranted an in-depth sociocultural tailoring of the curriculum to improve community receptiveness, in particular, revising the sessions to "narrativize" the materials to strengthen their potential effectiveness. This manuscript describes the novel recruitment strategies; the development of an enhanced MOCHA+ Stories Matter program that uses narrative communication strategies; and the methodology used to assess the comparative effectiveness of the MOCHA Standard relative to MOCHA+ Stories Matter program in lowering stress and risk of chronic diseases in a randomized controlled trial. The results of this research will contribute to the identification of effective interventions to address health disparities in low-income African-American men and the dissemination of effective chronic disease prevention programming.