This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Objective: To determine if Self Identity through Ho oponopono (SITH) used in addition to standard medical therapy (SMT) is associated with improved hypertension management (reduced blood pressure BP) in comparison to SMT used alone in the Asian, Hawaiian and other Pacific Islander (AHOPI) populations with hypertension (HTN).
Specific Aims /Questions: 1) Is there a significant difference between pre-test and post-test BP measurements in the AHOPI populations when SITH is included as additional therapy for participants receiving SMT for HTN? 2) Is there a significant difference in pre-test and post-test spirituality scores of participants of the AHOPI population regarding their sense of meaning and fulfillment of purpose in life, well-being, forgiveness, inner peace & love when SITH is included as additional therapy to SMT for HTN? Problem: 1) High BP affects almost 50 million Americans and 1 billion people worldwide and is the leading risk factor for heart disease & stroke. 2) HTN persists despite SMT and the prevalence steadily increases in both males/females in ethnic groups of Hawaii (HI) and results in one/three deaths in HI. 3) Pre-hypertension (PHTN) increases risk for HTN: normotensive persons at age 55 have a 90% lifetime risk for developing HTN. 4) There exists a $259 billion financial and social burden to the USA for HTN. Purpose: To determine if an association exists between SITH and HTN management when SITH is used in combination with SMT in the AHOPI population. To establish a basis for power needed to conduct a RCT for reducing HTN-related risks & health disparities in the target population. Significance: BP reduction is a major goal of Healthy People Objectives 2010. JNC 7 requires healthy lifestyle modifications to be a critical component in reducing BPs of people with the new classification of PHTN (SBP 120-139 mmHg or DBP 80-89 mmHg). No effective therapy exists currently. If SITH in conjunction with SMT improves BP control in the AHOPI population, it will offer a new culturally-appropriate treatment in HI & a method to reduce the leading risk factor for heart disease and stroke in the target population, reduce HTN-related deaths in HI, reduce the $259 billion financial and social burden in USA & the target population an improved sense of spirituality (well-being, meaning, fulfillment of purpose in life, forgiveness, inner peace & love). Methods: A. Design: Cross-over design for pretest & post-test study. Participants will serve as their own control. Assignment to pre-test group while receiving SMT for PHTH or HTN will begin 2 months prior to the intervention of SITH. B. Subjects: Inclusion Criteria: Adults from the AHOPI population aged 35 years and older with PHTN or stable, well-controlled HTN with minimal changes in anti-hypertensive medications for at least 2 months prior to the start of the study will be invited to enroll in the SITH study. Oversampling will allow for l0% attrition. Exclusion Criteria: Persons with unstable BPs or who are pregnant, incarcerated, planning to relocate from Oahu, likely to have medication changes or at increased risk for serious disease/death. C. Variables: Predictor: Participation in a SITH Plus Training. Outcome: 1) Reduction in BPs as measured by approved automatic standard BP devices from pre-test means. 2) Improved self-report scores of participants spiritual well-being, meaning, fulfillment of purpose in life, forgiveness, inner peace and love factors. D. Sample: 38 participants from the AHOPI population. (Power of 80%, alpha 0.05, repeated measures analyses).
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