Perceived stress is inversely related to ideal cardiovascular health: The Paris Prospective Study III

Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program

BACKGROUND

Poor mental health is a leading cause of morbidity and mortality among Black men in the United States. Efforts to improve mental health among Black men have been hampered by a lack of access and utilization of mental health services. Physical activity and social networks have been shown to improve mental health. Thus, we examined the effect of a community team-based physical activity, health education and social needs intervention among Black men on mental health over 24 weeks.

METHODS

Black adult males (n = 74) from a large Midwestern city participated in Black Impact, a 24-week community-based lifestyle change program adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Measures of mental health including the Center for Epidemiological Studies Depression Scale (CES-D), Patient Health Questionnaire 2-question depression screener (PHQ-2), and Perceived Stress Scale-10 (PSS-10) were completed at baseline, 12 and 24 weeks. The change in mental health scores from baseline to 12 and 24 weeks were evaluated using linear mixed-effects models adjusting for age, education, and income. The change in cardiovascular health scores, defined as objective metrics of LS7 (LS5 [blood pressure, total cholesterol, fasting glucose, body mass index and smoking]), by baseline mental health were evaluated using linear mixed-effects models with an interaction term (time*baseline mental health variable) and a random intercept for each participant.

RESULTS

Among 71 Black men (mean age 51, 85% employed) at 24 weeks, CES-D scores decreased from 10.54 to 7.90 (-2.64, 95%CI:-4.74, -0.55), PHQ-2 decreased from 1.04 to 0.63 (-0.41, 95%CI: -0.75, -0.07), and PSS-10 decreased from 14.62 to 12.91 (-1.71, 95%CI: -3.53, 0.12). A 1-unit higher CES-D at baseline was associated with less improvement in LS5 scores by -0.04 (95%CI: -0.076, -0.005) and - 0.032 (95%CI:-0.067, 0.003) units at week 12 and 24, respectively, with similar findings for PSS.

CONCLUSIONS

The Black Impact community-based lifestyle program has the potential to reduce depressive symptoms and stress in Black men. There is a dire need for larger, randomized studies to test the impact of Black Impact on mental health in Black men to advance health equity.

TRIAL REGISTRATION

Retrospectively Registered, ClinicalTrials.gov Identifier: NCT04787978.

The effect of an instant message-based lifestyle and stress management intervention on the reduction of cardiovascular disease risk

AIM

This study investigated the effectiveness of an instant message-based lifestyle and stress management intervention delivered by nurses on cardiovascular disease risk reduction.

METHODS

In this nonrandomized concurrent controlled trial conducted from March 2013 to September 2013, 164 eligible employees in two companies were assigned to the intervention (n = 83) and control (n = 81) groups based on their worksites. Only participants were blinded to group assignment. All participants received two education sessions during 1 month, and the intervention group also received an instant message-based lifestyle and stress management intervention for 5 months. The primary outcome was the Framingham Risk Score, and the data were collected at the first month and the sixth month.

RESULTS

The final analysis included 80 participants in the intervention group and 76 in the control group. After the intervention, significant intervention effects were found for the mean value and the changes of the Framingham Risk Score and the proportion of participants who improved their diet and exercise (P < 0.05). There were trends for improvement in the proportion of smoking and levels of stress, but statistically significant levels (P > 0.05) were not met.

CONCLUSION

An instant message-based lifestyle and stress management intervention can reduce cardiovascular disease risk in high-risk individuals.

Associations between sleep, stress, and cardiovascular health in emergency medical services personnel

OBJECTIVE

Our objective was to quantify the associations between sleep duration and perceived and chronic stress with ideal cardiovascular health (CVH) among emergency medical services (EMS) personnel from county-based EMS agencies.

METHODS

We conducted a cross-sectional survey of cardiovascular disease (CVD)-free EMS personnel from 4 US EMS agencies. The questionnaire consisted of the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Chronic Burden Scale, and the CVH components (smoking, body mass index, physical activity, diet, blood glucose, blood pressure, cholesterol, each scored 0-2 points). The components were summed and ideal CVH considered 11-14 points. Mixed effects logistic regression models with a random intercept for agency were used to estimate the odds of ideal CVH for good sleep quality (PSQI < 5 points), recommended sleep duration (7 to < 9h), low perceived stress (PSS < 26 points), and low chronic stress (0 recent stressful events).

RESULTS

We received 379 responses (response rate = 32%). There was low prevalence of good sleep quality (23%) and recommended sleep duration (25%), but 95% reported low perceived stress, and 33% had low chronic stress. Ideal CVH was reported by 30%. No significant associations between ideal CVH and sleep quality, perceived stress, or chronic stress were found. There was a nearly 2-fold increase in the odds of ideal CVH with recommended sleep duration (odds ratio: 1.83, 95% confidence interval: 1.08-3.10).

CONCLUSION

In this sample of EMS personnel, only recommended sleep duration was associated with ideal CVH. Future longitudinal studies are needed to understand the relationship between sleep, stress, and CVD in this understudied occupational group.

Stress Monitoring and Recent Advancements in Wearable Biosensors

The stress response allows the body to overcome obstacles and prepare for threats, but sustained levels of stress can damage one's health. Stress has long been measured through physical tests and questionnaires that rely primarily on user-inputted data, which can be subjective and inaccurate. To quantify the amount of stress that the body is experiencing biologically, analytical detection of biomarkers associated with the stress response recently have been developed. Novel stress sensing devices focus on cortisol sweat sensing as a part of wearable, flexible devices. These devices promise a real-time, continuous collection of stress data that can be used in clinical diagnoses or for personal stress monitoring and mediation.