Abstract
Background: Black Americans are disproportionally affected by venous thromboembolism (VTE) and experience higher incidence, greater clinical severity and increased age-adjusted mortality compared to other racial and ethnic groups. Despite this elevated risk, awareness and education about VTE remain limited in many black communities. The National Blood Clot Alliance (NBCA) is a nonprofit health organization committed to raising awareness, promoting prevention, and supporting early diagnosis and treatment of VTE. One of NBCA's most ambitious community driven initiatives to date is the B.L.A.C.K. Church Bus Tour (Black Lives Advocating for Clot Knowledge), a first of its kind outreach program that partners with faith-based institutions to serve as a trusted source of health education in Black communities.
Objective: Assess the feasibility and impact of a community-based bus tour campaign collaborating with Black churches across the southeastern United States to increase awareness and knowledge of VTE.
Methods: In March 2025, during blood clot awareness month, the NBCA launched its first B.L.A.C.K Church Bus Tour. The team traveled to five cities as part of an educational program. These locations were strategically chosen based on data from the Southern Communities Initiative, which indicates that approximately 55% of Black Americans reside in or near these areas. Survey data collection occurred at 4 of the 5 sites due to inclement weather at one of the sites. In partnership with Black patients and clinicians serving as thrombosis advocates, the tour incorporated the distribution of educational materials and the administration of pre- and post-event surveys to assess changes in knowledge. Paired pre- and post-survey responses were analyzed to evaluate the impact of the intervention. McNemar's test was used to compare answers by question and Wilcoxon signed rank test was used to compare section and total scores pre and post-program.
Results: There were a total of 450 participants who attended a workshop event. A total of 93 paired surveys were collected across four sites. An additional 61 unmatched surveys (44 pre, 17 post) were excluded from analysis.
Age distribution varied by site. The majority were aged 61–70 years (27.96%), followed by those aged 71–80 years (22.58%). Smaller proportions were observed in the 51–60 (15.05%), under 30 (11.83%), 41–50 (8.60%), and 30–40 (7.53%) age groups. The least represented categories were 81+ years. Across all sites, most respondents identified as female (73.1%). The vast majority (85%) identified as Black, non-Hispanic. Additionally, 89.2% of respondents reported no personal or history of VTE and no history of VTE among friends or family members.
Post-program survey responses demonstrated consistent improvements in knowledge and awareness across 16 measured items. These items spanned multiple domains, including 4 related to general familiarity with VTE and its associated mortality, 3 focused on prevention strategies, 1 addressing epidemiological data, 4 concerning symptom recognition, and 4 covering treatment options. There was a statistically significant increase in knowledge in general familiarity with VTE and its associated mortality (median score change 1, IQR: 0-2, p <0.0001), symptom recognition (median score change 1, IQR 0-2, p <0.0001), and treatment options (median score change =0, IQR 0-1, p= 0.002). Participants' total knowledge score significantly increased post program (median score change 2, IQR 0-5, p <0.0001). The greatest increase in knowledge was observed in participants' awareness of the signs and symptoms of VTE. Across all sites, 75-100% of respondents strongly agreed that they intended to share information learned about VTE with family, friends, and/or colleagues.
Conclusion: The B.L.A.C.K Church Bus Tour was a successful campaign event that effectively improved participants' knowledge and awareness of VTE. Post-program survey responses showed consistent increases in knowledge. Notably, the vast majority of participants expressed an intention to disseminate information learned, suggesting the program's potential for broader community impact through peer education and awareness. These results underscore the value of culturally tailored educational interventions in addressing gaps in VTE awareness, supporting calls for public health campaigns to reduce the burden of this preventable condition through improved knowledge and peer-driven dissemination.
