A major cause of the disproportionate rate of coronary heart disease and other cardiovascular disease in African American women is the high prevalence of hypertension in this population. Compared with Whites, hypertension develops earlier in life and average blood pressures are much higher in African Americans. Evidence suggests that the likelihood of developing hypertension is increased among individuals who experience continued psychological stress. Studies on emotions and behaviors associated with the stress process indicate that anger, anger expression style, and coping behaviors have particular relevance for hypertensive African American women. Cognitive behavioral therapy, a type of stress management, emphasizes improving the person's competency in handling significant aspects of the surrounding world. The core components of a cognitive behavioral intervention are arousal/ emotional reduction (relaxation) and cognitive mediation. The long-term goal of the applicant is to obtain extramural funding to evaluate a nonpharmacological intervention to assist African American women in modifying their cognitive and behavioral responses to stress. To accomplish this goal, the applicant will pursue a career development program consisting of (a) clinical management of hypertension, (b) clinical trials research, (c) data analyses and management, and (d) cultural competence in research. This training will be applied to the specific aims of the research program: (a) Design and pilot two cognitive/ behavioral interventions (relaxation and cognitive mediation) for hypertensive African American women (N=90), (b) Determine the effectiveness of the two approaches as compared to a traditional educational program, (c) Compare the relative effectiveness of the two approaches (relaxation and cognitive mediation), and (d) Develop a competitive RO1 research application based on findings of the pilot intervention. Study variables for the research plan will be evaluated with State-Trait Anger Expression Inventory, the Personal Strain Questionnaire, and the Coping Resources Questionnaire. waist/ hip ratios, and blood pressure. An orthogonal set of single-degree-of-freedom interaction contrasts will be used to determine the effectiveness of the two approaches as compared to a traditional educational program. A single-degree-of-freedom interaction contrast will be used to compare the relative effectiveness of the two approaches (relaxation and cognitive mediation). Findings from the pilot interventions will be used to refine and develop a RO1 proposal for consideration of extramural funding.
| Webb, Mary; Beckstead, Jason; Meininger, Janet et al. (2006) Stress management for African American women with elevated blood pressure: a pilot study. Biol Res Nurs 7:187-96 |
