African American Stress Intervention Study- Feasibility in Hypertension: (ASIS-Feasibility HTN Cohort)

TJ Exford, Ph.D., MEd
North Carolina Agricultural and Technical State University

African Americans are disproportionately exposed to chronic stressors, including low socioeconomic status, discrimination, and relationship stress, which contributes to health disparities. Chronic stress and dysfunctional health behaviors within African American populations influence health and are associated with HTN occurrence and management. Recommendations have been made for the implementation of non-pharmacological lifestyle interventions incorporating stress management to support hypertension treatment in AA. Stress reduction strategies designed to intervene on stress-related behavioral coping processes as an adaptive response to negative thoughts and experiences have been shown to reduce blood pressure in older AA with HTN. However, these studies are limited by a lack of engagement of AA and a lack of attention to lived experiences of racism and discrimination. The current study will address these research gaps by targeting African Americans and culturally adapting stress reduction programming with attention to values and beliefs (i.e. spirituality and religion), relevant psychological stressors (i.e. discrimination and racism), and logistics (i.e. reduced time of sessions and offering classes in familiar community setting) in this group.

Studies targeting African Americans with hypertension have been applied using transcendental meditation, but these studies did not apply mindfulness. Mindfulness meditation is a well-established and studied strategy to reduce stress and potentially improve health outcomes. However, the practice of mindfulness meditation is largely underutilized in African American communities despite its potential health benefits. To date, there is limited extant research, evaluating a culturally tailored lifestyle intervention of mindfulness stress reduction as adjunctive treatment in the control of blood pressure to reduce cardiovascular disease risk in older African Americans. We utilize a non-pharmacological, culturally tailored stress management strategy as an adjunct to pharmacological hypertension treatment to reduce blood pressure in adults, and mitigate the associated risk of hypertension in cardiovascular disease related events. We hypothesize that by offering the intervention incorporating cultural values and using culturally-familiar terminology within a culturally familiar setting will mitigate barriers to engagement in a culturally tailored MBSR program.