Chronic life stress is an antecedent to chronic illnesses like cardiovascular disease. The multitude of competing chronic stressors experienced by midlife Black women contribute to the striking disparities in cardiovascular disease morbidity and mortality in comparison to midlife White American women. These same stressors also decrease the likelihood that Black women will adopt healthy lifestyle behaviors as they diminish the time and energy available for self-care. Physiological and psychological responses to social and environmental stressors are uniquely influenced by a population's history, perceptions, and culture. The intersection between ethnicity, culture, environment, and health is complex and requires tailored and targeted approaches that account for population differences to improve health outcomes. Recognition and improved understanding of these potential differences is important to provide culturally appropriate care. The purpose of this research is to develop a midlife Black women's Stress-reduction WELLness intervention, B-SWELL, to promote healthy lifestyle behaviors based on the stressors and themes identified in the candidate's preliminary research. Community-based participatory research (CBPR) methods will be used to engage the community and include midlife Black women in the development of the B-SWELL. The hypothesis proposes that B-SWELL participants (n=25) will show improved self-efficacy in managing life stress and adopting American Heart Association's Life Simple 7 Success Plan (LS7 behaviors), compared with participants randomized to a control group receiving traditional wellness education (WE group) (n=25). Secondary outcomes include unhealthy days, perceived general health and depressive symptoms. Data collection will occur at baseline, 8 weeks (end of intervention), and 12 weeks. LS7 has been shown to decrease cardiovascular disease risk but lacks culturally appropriate characteristics to improve its appeal to midlife Black women. The candidate, Dr. Jones, has expertise in stress research with a focus on chronic life stress in midlife Black women. In an effort to develop an effective intervention for midlife Black women, the candidate assembled a mentoring team of experts to guide her training in intervention research and community-based participatory research methods (CBPR). Dr. Jones' short-term goal is to become an independent stress researcher skilled in the use of methodologies and techniques required for intervention research and CBPR. This K01 award will serve as a platform from which Dr. Jones will build a body of stress research focused on chronic disease prevention in midlife Black women. The resources, time, and, materials needed for this project are available through the University of Cincinnati (UC) and the College of Nursing. In addition, the UC Center for Clinical & Translational Training and Science offers services for K01 awardees in the effort to foster junior researchers.
This research is relevant to public health because it studies the unique cultural and gender- based factors that influence how midlife Black women experience stress and incorporate healthy lifestyle behaviors into daily life. In this ever-changing and diverse society, our ability to provide individualized and culturally appropriate interventions, like the B-SWELL, is important. The proposed B-SWELL intervention has the potential to elucidate the complex relationship between stress and behavior and affect existing cardiovascular health disparities.
