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Walker MS, Figueiredo NR, de Lara Machado W, Costa CAD, Feoli AMP. Cognitive-behavioral therapy for treating hypertension: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2024; 29:411-426. [PMID: 37990412 DOI: 10.1080/13548506.2023.2282958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/07/2023] [Indexed: 11/23/2023]
Abstract
The aim of the study is to investigate whether cognitive behavioral therapy (CBT) can help in reducing blood pressure (BP) in patients with hypertension, both systolic blood pressure (SBP) and diastolic blood pressure (DBP), this being the primary outcome. This was a systematic review with a meta-analysis that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The keywords used for the searches were CBT and hypertension and their respective synonyms, and were applied to the Pubmed, EMBASE and Web of Science databases. Eligibility and data extraction were performed by two independent researchers. They assessed the risk of bias using the Cochrane's RoB 2 tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of the evidence. The data was pooled on the basis that all the analyses had a random effects model. Twenty-two studies were included in this review. In the meta-analysis, 11 studies were included in the analyses of the BP outcomes (SBP and DBP), five studies were included in the follow-up evaluation, and two studies in the body mass index (BMI) analysis. The searches included a total of 2897 patients. The studies presented a high risk of bias and very low quality of evidence. We observed an effect of -0.65 (95% CI: -0.91; -0.39) for CBT-based interventions on SBP with high heterogeneity (I2 85%) and a higher effect of -0.78% (95% CI: -1.13; -0.43) on DBP with even greater heterogeneity (I2 92%). We observed that CBT did have an effect on reducing BP and BMI in hypertensive adults. However, due to the considerable heterogeneity between the studies, the high risk of bias, and the low overall quality of evidence, confidence in these findings should be limited.
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Affiliation(s)
- Marthina S Walker
- Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sulepartment, Porto Alegre, Brasil
| | - Natália R Figueiredo
- Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sulepartment, Porto Alegre, Brasil
| | - Wagner de Lara Machado
- Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sulepartment, Porto Alegre, Brasil
| | - Caroline A D Costa
- Post-Graduation Program in Child-Adolescent Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brasil
| | - Ana Maria P Feoli
- Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sulepartment, Porto Alegre, Brasil
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Gaskin DJ, Zare H, Ibe CA, Yang M, Jones W, Gaston M, Porter G, Woods DL, Balamani M, Jones N, Rose VA, Williams RA, Rohde C. The impact of the Prime Time Sister Circles® (PTSC) on blood pressure of low-income mid-life African American women in the United States. J Public Health Policy 2023; 44:616-633. [PMID: 37899483 PMCID: PMC10709469 DOI: 10.1057/s41271-023-00450-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/31/2023]
Abstract
There is a pressing need to develop and evaluate culturally tailored, community-based interventions that address hypertension management among low-income African American women. We employed a randomized controlled trial to test the effectiveness of the Prime Time Sister Circles® Program in reducing blood pressure and body mass index among low-income African American women ages with hypertension. Study participants (N = 339) were African American women aged 40-75 years who were diagnosed with hypertension and received their primary care at government funded health centers in Washington, D.C. Compared to the usual care group, Prime Time Sister Circles® participation was associated with a reduction in systolic BP by - 2.45 (CI - 6.13, 1.23) mmHg, a reduction in diastolic BP by - 3.66 mmHg (CI - 6.32, - 0.99), and a change in BMI by - 0.26 (CI - 2.00, 1.48) from baseline to 15 months. The results suggest that culturally tailored community-based interventions can improve hypertension management in low-income women.
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Affiliation(s)
- Darrell J Gaskin
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD, USA.
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway Ste 441, Baltimore, MD, 21205-1900, USA.
| | - Hossein Zare
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Global Health Services and Administration, University of Maryland Global Campus, Adelphi, MD, USA
| | - Chidinma A Ibe
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD, USA
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Wehmah Jones
- American Institutes for Research, Washington, DC, USA
| | - Marilyn Gaston
- The Gaston & Porter Health Improvement Center, Inc., Washington, DC, USA
| | - Gayle Porter
- The Gaston & Porter Health Improvement Center, Inc., Washington, DC, USA
| | - Denise L Woods
- The Gaston & Porter Health Improvement Center, Inc., Washington, DC, USA
| | | | - Nicole Jones
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Richard Allen Williams
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Charles Rohde
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Singh H, Fulton J, Mirzazada S, Saragosa M, Uleryk EM, Nelson MLA. Community-Based Culturally Tailored Education Programs for Black Communities with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: Systematic Review Findings. J Racial Ethn Health Disparities 2023; 10:2986-3006. [PMID: 36508135 PMCID: PMC10645635 DOI: 10.1007/s40615-022-01474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Community-based culturally tailored education (CBCTE) programs for chronic diseases may reduce health disparities; however, a synthesis across chronic diseases is lacking. We explored (1) the characteristics and outcomes of CBCTE programs and (2) which strategies for culturally appropriate interventions have been used in CBCTE programs, and how they have been implemented. METHODS A systematic review was conducted by searching three databases to identify empirical full-text literature on CBCTE programs for Black communities with cardiovascular disease, hypertension, diabetes, or stroke. Studies were screened in duplicate, then data regarding study characteristics, participants, intervention, and outcomes were extracted and analyzed. Cultural tailoring strategies within programs were categorized using Kreuter and colleagues' framework. RESULTS Of the 74 studies, most were conducted in the USA (97%) and delivered in one site (53%; e.g., church/home). CBCTE programs targeted diabetes (65%), hypertension (30%), diabetes and hypertension (1%), cardiovascular disease (3%), and stroke (1%). Reported program benefits included physiological, medication-related, physical activity, and literacy. Cultural tailoring strategies included peripheral (targeted Black communities), constituent-involving (e.g., community informed), evidential (e.g., integrated community resources), linguistic (e.g., delivered in community's dialect/accent), and sociocultural (e.g., integrated community members' religious practices). CONCLUSIONS CBCTE programs may have beneficial outcomes, but a small sample size limited several. The strategies identified can be adopted by programs seeking to culturally tailor. Future interventions should clearly describe community members' roles/involvement and deliver programs in multiple locations to broaden reach. TRIAL REGISTRATION PROSPERO CRD42021245772.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, Toronto, ON, M5G 1V7, Canada.
- KITE, Toronto Rehabilitation Institute, University Health Network, 520 Sutherland Drive, Toronto, ON, Canada.
- Temerty Faculty of Medicine, Rehabilitation Science Institute, University of Toronto, 500 University Avenue Toronto, Toronto, ON, M5G 1V7, Canada.
| | - Joseph Fulton
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, 10 Overlea Blvd, Toronto, ON, Canada
| | - Sofia Mirzazada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, Toronto, ON, M5G 1V7, Canada
| | - Marianne Saragosa
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 1 Bridgepoint Drive, Toronto, ON, Canada
| | | | - Michelle L A Nelson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, 10 Overlea Blvd, Toronto, ON, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 1 Bridgepoint Drive, Toronto, ON, Canada
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Jones MK, Davis SM, Gaskin-Cole G. An Integrative Review of Sistah Circles in Empirical Research. PSYCHOLOGY OF WOMEN QUARTERLY 2023. [DOI: 10.1177/03616843231154564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Sistah circles are spaces shared by Black women who share similar goals, exchange resources (e.g., support), and invest in developing strong relational bonds over time. Considering the significance of sistah circles for Black women's wellness and survival, in this study we examined how this phenomenon has been researched in the social sciences literature and, in turn, offered a more refined conceptual definition and framework that will direct future research on this topic. Specifically, we completed an integrative review of empirical studies on sistah circles using social science databases and search engines to identify relevant literature. Articles included for review met the following criteria: (a) published between 2000 and 2020, (b) analyzed empirical data, (c) were composed of Black women participants, and (d) mentioned Black women groups or friendships. Qualifying sources ( N = 45) were organized into a taxonomy of three types of sistah circles: health-focused, social, and professional. We also analyzed sample characteristics, research methods, and publication trends across all of the articles included in the review. Based upon our taxonomy and results of our review, we highlight the strengths and limitations of the current scholarship focused on Black women's sistah circles and offer suggestions regarding future research and practice. Additional online materials for this article are available on PWQ's website at http://journals.sagepub.com/doi/suppl/10.1177/03616843231154564
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Affiliation(s)
| | - Shardé M. Davis
- Department of Communication, University of Connecticut, Storrs, CT, USA
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Stress Reduction to Decrease Hypertension for Black Women: A Scoping Review of Trials and Interventions. J Racial Ethn Health Disparities 2022; 9:2208-2217. [PMID: 34606073 DOI: 10.1007/s40615-021-01160-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Chronic stress is a potential root cause of racial/ethnic disparities in cardiovascular disease. This review assesses literature surrounding effective stressreduction interventions to reduce hypertension (HTN)-a cardiovascular disease (CVD) risk factor-among an understudied population, non-Hispanic black (NHB) women. METHODS We conducted an electronic search of PubMed and PsycINFO literature published between January 1, 2000 and February 1, 2020, employing the keywords: "blood pressure", "hypertension", and "women", "black", "African-American", "stress", "meditation", "stress-coping", "stress-management", and "faith-based". We manually searched the bibliographies for additional articles. Studies were excluded if they: were published before 2000; were not intervention-based; did not study Black women in the US; did not target stress reduction; or did not measure blood pressure as an outcome. Independent reviewers screened the articles, which were selected based on consensus. Effect sizes and statistical p values were reported as provided in the included articles. RESULTS We identified 109 articles in total. Of those, six articles met inclusion criteria. Stronger evidence presented by a randomized control trial supported the efficacy of transcendental meditation with reductions in systolic and diastolic blood pressure up to 7 mmHg. Relaxation exercises, support groups, and therapeutic massage emerged as potentially beneficial in non-randomized pilot trials with reductions in systolic BP up to 9 mmHg and diastolic BP up to 5 mmHg varying by type and duration of the intervention. CONCLUSIONS This scoping review found that faith-based strategies and meditation can be effective stress reduction techniques to reduce BP among NHB women. However, much remains to be known about how these strategies may be leveraged to reduce blood pressure within this highly vulnerable population.
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Spikes T, Higgins M, Lewis T, Dunbar SB. The associations among illness perceptions, resilient coping, and medication adherence in young adult hypertensive black women. J Clin Hypertens (Greenwich) 2019; 21:1695-1704. [PMID: 31556484 PMCID: PMC6851441 DOI: 10.1111/jch.13712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/23/2019] [Accepted: 09/02/2019] [Indexed: 02/02/2023]
Abstract
Hypertension, a modifiable risk factor of cardiovascular disease, is largely responsible for the disproportionate morbidity and mortality in black women. Black women 20 years of age and older have a higher prevalence of HTN compared to white women (44% vs 28%). Poor adherence and non-adherence to hypertensive medications have been strongly indicated as a primary contributor to the early onset of disparity in cardiovascular disease morbidity and mortality experienced by black people. The purpose of this study was to examine medication adherence in black women relative to sociodemographic, clinical, cultural context, psychosocial, cognitive, and behavioral factors. This was a prospective, descriptive cross-sectional study of N = 85, hypertensive black women, with mean age of 39 ± 5.4 years, 18-45 years of age. Variables and measures included: sociodemographic characteristics, clinical, adverse social stressors, psychosocial, cognitive-behavioral factors, and medication adherence. Descriptive statistics, correlations, multivariate logistic regressions, and moderation analysis were tested. 81.2% (n = 69) of the sample was categorized as non-adherent. SBP was the only clinical covariate associated with HTN medication adherence. HTN illness perceptions, composite score, resilient coping, depressive symptoms, exposure to lifetime gender, and racial stressors, were not associated with HTN medication adherence. Using multivariate logistic regression, decreased SBP and lower scores on the "Consequence" dimension of the HTN illness perception scale were associated with medication adherence (χ2 = 10.53, P = .001). Adherence was associated with both the "Consequence" and "Identity" dimensions of the HTN illness perception scale indicating the need and importance for clinicians to have open and honest communication regarding HTN and its treatment in facilitating adherence.
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Affiliation(s)
- Telisa Spikes
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgia
| | - Melinda Higgins
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgia
- Rollins School of Public HealthEmory UniversityAtlantaGeorgia
| | - Tene’ Lewis
- Rollins School of Public HealthEmory UniversityAtlantaGeorgia
| | - Sandra B. Dunbar
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgia
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Pesantes MA, Lazo-Porras M, Abu Dabrh AM, Ávila-Ramírez JR, Caycho M, Villamonte GY, Sánchez-Pérez GP, Málaga G, Bernabé-Ortiz A, Miranda JJ. Resilience in Vulnerable Populations With Type 2 Diabetes Mellitus and Hypertension: A Systematic Review and Meta-analysis. Can J Cardiol 2015; 31:1180-8. [PMID: 26239007 PMCID: PMC4556590 DOI: 10.1016/j.cjca.2015.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 06/11/2015] [Accepted: 06/11/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Patients with chronic conditions and limited access to health care experience stressful challenges resulting from the burden of managing both their conditions and their daily life demands. Resilience provides a mechanism of adapting to stressful experiences. We conducted a systematic review and meta-analysis to synthesize the evidence about interventions to enhance resiliency in managing hypertension or type 2 diabetes in vulnerable populations and to assess the efficacy of these interventions on clinical outcomes. METHODS We searched multiple databases from early inception through February 2015 including randomized controlled trials that enrolled patients with type 2 diabetes or hypertension. All interventions that targeted resilience in vulnerable populations were included. Data were synthesized to describe the characteristics and efficacy of resiliency interventions. We pooled the total effects by calculating standardized mean difference using the random-effects model. RESULTS The final search yielded 17 studies. All studies were conducted in the United States and generally targeted minority participants. Resiliency interventions used diverse strategies; discussion groups or workshops were the most common approach. CONCLUSIONS Interventions aimed at enhancing the resiliency of patients from vulnerable groups are diverse. Outcomes were not fully conclusive. There was some evidence that resiliency interventions had a positive effect on hemoglobin A1C levels but not blood pressure. The incorporation of resiliency-oriented interventions into the arsenal of preventing and managing chronic conditions appears to be an opportunity that remains to be better investigated and exploited, and there is need to pursue further understanding of the core components of any intervention that claims to enhance resilience.
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Affiliation(s)
- M Amalia Pesantes
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Abd Moain Abu Dabrh
- Knowledge and Evaluation Research (KER) Unit Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Jaime R Ávila-Ramírez
- Knowledge and Evaluation Research (KER) Unit Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - María Caycho
- Knowledge and Evaluation Research (KER) Unit Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Georgina Y Villamonte
- Knowledge and Evaluation Research (KER) Unit Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Grecia P Sánchez-Pérez
- Knowledge and Evaluation Research (KER) Unit Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Germán Málaga
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
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8
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Atkins R. Validation of the Center for Epidemiologic Studies Depression Scale in black single mothers. J Nurs Meas 2015; 22:511-24. [PMID: 25608436 DOI: 10.1891/1061-3749.22.3.511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to investigate the factor structure of the Center for Epidemiologic Studies Depression (CES-D) scale in a community sample of Black single mothers and to evaluate the scale's construct validity. METHODS Principal components and exploratory factor analysis were used. The participants responded to the CES-D scale and Spielberger's State-Trait Anger Expression Inventory. RESULTS The final sample consisted of 208 Black single mothers aged 18-45 years. A 2-factor structure was accepted. Construct validity was confirmed via significant correlations with the anger scales. A method artifact for the 2-factor solution was ruled out. CONCLUSION The CES-D scale is valid for use with Black single mothers. Additional psychometric evidence for the CES-D for Black single mothers is warranted.
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Schlomann P, Virgin S, Schmitke J, Patros S. Hypertension among the uninsured: tensions and challenges. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2011; 23:305-313. [PMID: 21649773 DOI: 10.1111/j.1745-7599.2011.00616.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To explore the experience of living with hypertension (HTN) in uninsured Southern, Appalachian adults who receive care in a nurse practitioner-run clinic. DATA SOURCES Focus groups with 16 clients. CONCLUSIONS Living with hypertension encompassed living with many tensions and challenges. It was described by five organizing themes, each of which involved two basic themes held in tension. The organizing themes were: (a) centrality of HTN; (b) controllability of HTN; (c) visibility of HTN, (d) accessibility and quality of health care; and (e) existential reality. IMPLICATIONS FOR PRACTICE Interventions are needed to help clients deal with the tensions and challenges; these include a greater focus on partnering with clients, individual and group educational activities, and developing community partnerships.
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Affiliation(s)
- Pam Schlomann
- Eastern Kentucky University, Richmond, Kentucky, USA.
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Abstract
BACKGROUND AND OBJECTIVE Medication adherence is low among hypertensive patients regardless of ethnic background. However, the prevalence of nonadherence is higher among African Americans when compared with their white American counterparts. Recognizing African American perspectives about their adherence to antihypertensive medications is necessary for the development of successful interventions aimed at improving adherence to prescribed regimens. The purpose of this qualitative study was to explore community-dwelling hypertensive African American behavioral, normative, and control beliefs regarding their adherence to antihypertensive medications. SUBJECTS AND METHODS A community and academic partnership was formed to conduct 3 audio-taped focus groups with 40 hypertensive and low-income African American adults aged 18 years and older. Interview questions were based on the theory of planned behavior. All transcripts from the tapes were analyzed using thematic analysis. RESULTS AND CONCLUSIONS Behavioral beliefs associated with medication adherence identified both positive and negative outcomes. Family, friends, neighbors, and God were associated with normative beliefs. Limited financial resources, neighborhood violence, and distrust of healthcare professionals were key control beliefs. Although these results cannot be generalized, they do provide significant insight into the contextual factors associated with the lives of community-dwelling hypertensive African Americans who fit a similar demographic profile. These findings are important because they can be used to tailor interventions to increase their medication adherence.
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Shehata MF. A Proposed Study on how Far Anger Contributes to Initiating Essential Hypertension in Canadian Caucasian Adults with a Family History of Hypertension. CLINICAL MEDICINE INSIGHTS: CARDIOLOGY 2010. [DOI: 10.1177/117954681000400001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The goal of the present correlational study is to test the hypothesis that anger initiates essential hypertension in Canadian Caucasian adults with a family history of hypertension. The study population will include a cohort of 100 men and women aged 25 to 45 years at enrollment recruited from the University of Ottawa General and Civic Hospitals. Participants who are normotensives will be included in the study given that they have a family history of hypertension. The Spielberger State Trait Anger Expression inventory (STAXI) scales will assess the three main dimensions of anger: State, Trait and Anger Expression. Using a semiautomated blood pressure machine, blood pressure measurements will be conducted by the attending nurse. It is hypothesized that during the three year study, participants with higher STAXI scores will more likely develop hypertension. Results obtained from the present study are expected to highlight the significant contribution of anger as a modifiable behavioral risk factor in the pathogenesis of hypertension.
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Affiliation(s)
- Marlene F. Shehata
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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12
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An integrative review of interventions to reduce peripheral arterial disease risk factors in African Americans. JOURNAL OF VASCULAR NURSING 2009; 27:31-45. [DOI: 10.1016/j.jvn.2009.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 02/19/2009] [Accepted: 02/23/2009] [Indexed: 11/23/2022]
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Fonseca FDCA, Coelho RZ, Nicolato R, Malloy-Diniz LF, Silva Filho HCD. A influência de fatores emocionais sobre a hipertensão arterial. JORNAL BRASILEIRO DE PSIQUIATRIA 2009. [DOI: 10.1590/s0047-20852009000200011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Realizar revisão bibliográfica de artigos que abordam a relação entre hipertensão arterial e fatores emocionais, levando em consideração a relevância do tema. MÉTODOS: Fez-se busca ativa na Biblioteca Virtual em Saúde, na base de dados MedLine (1997-2008), utilizando palavras da língua portuguesa. Os descritores de assunto escolhidos foram "hipertensão" e "doença cardíaca coronária". Em seguida, refinou-se a busca com os termos "hostilidade", "raiva", "ansiedade", "comportamento impulsivo" e "personalidade impulsiva". Não foram selecionados artigos que tratavam exclusivamente de doenças cardiovasculares e fatores psicológicos ou que associavam hipertensão e doenças cardiovasculares com depressão e doença de Alzheimer. RESULTADOS E DISCUSSÃO: Há inconsistência nos achados que relacionam os fatores emocionais com a hipertensão arterial e cardiopatias. Foram encontrados tanto estudos que demonstram relação positiva da raiva, hostilidade, ansiedade, impulsividade e estresse com hipertensão e doenças cardiovasculares quanto estudos que retratam relações negativas. CONCLUSÃO: O que se pode inferir das relações pesquisadas é que o risco de desenvolvimento da hipertensão arterial e a reatividade cardiovascular parecem ser influenciados por fatores emocionais como impulsividade, hostilidade, estressores, ansiedade e raiva. No entanto, mais estudos são necessários para melhor elucidar essas relações.
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Affiliation(s)
| | | | - Rodrigo Nicolato
- Universidade Federal de Ouro Preto; Instituto de Previdência dos Servidores do Estado de Minas Gerais
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Dickinson HO, Campbell F, Beyer FR, Nicolson DJ, Cook JV, Ford GA, Mason JM. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev 2008:CD004935. [PMID: 18254065 DOI: 10.1002/14651858.cd004935.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Lifestyle interventions are often recommended as initial treatment for mild hypertension, but the efficacy of relaxation therapies is unclear. OBJECTIVES To evaluate the effects of relaxation therapies on cardiovascular outcomes and blood pressure in people with elevated blood pressure. SEARCH STRATEGY We searched the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, ISI Proceedings, ClinicalTrials.gov, Current Controlled Trials and reference lists of systematic reviews, meta-analyses and randomised controlled trials (RCTs) included in the review. INCLUSION CRITERIA RCTs of a parallel design comparing relaxation therapies with no active treatment, or sham therapy; follow-up >/=8 weeks; participants over 18 years, with raised systolic blood pressure (SBP) >/=140 mmHg or diastolic blood pressure (DBP) >/=85 mmHg); SBP and DBP reported at end of follow-up. EXCLUSION CRITERIA participants were pregnant; participants received antihypertensive medication which changed during the trial. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Random effects meta-analyses and sensitivity analyses were conducted. MAIN RESULTS 29 RCTs, with eight weeks to five years follow-up, met our inclusion criteria; four were excluded from the primary meta-analysis because of inadequate outcome data. The remaining 25 trials assessed 1,198 participants, but adequate randomisation was confirmed in only seven trials and concealment of allocation in only one. Only one trial reported deaths, heart attacks and strokes (one of each). Meta-analysis indicated that relaxation resulted in small, statistically significant reductions in SBP (mean difference: -5.5 mmHg, 95% CI: -8.2 to -2.8, I2 =72%) and DBP (mean difference: -3.5 mmHg, 95% CI: -5.3 to -1.6, I2 =75%) compared to control. The substantial heterogeneity between trials was not explained by duration of follow-up, type of control, type of relaxation therapy or baseline blood pressure. The nine trials that reported blinding of outcome assessors found a non-significant net reduction in blood pressure (SBP mean difference: -3.2 mmHg, 95% CI: -7.7 to 1.4, I(2) =69%) associated with relaxation. The 15 trials comparing relaxation with sham therapy likewise found a non-significant reduction in blood pressure (SBP mean difference: -3.5 mmHg, 95% CI: -7.1 to 0.2, I(2) =63%). AUTHORS' CONCLUSIONS In view of the poor quality of included trials and unexplained variation between trials, the evidence in favour of causal association between relaxation and blood pressure reduction is weak. Some of the apparent benefit of relaxation was probably due to aspects of treatment unrelated to relaxation.
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Affiliation(s)
- Heather O Dickinson
- University of Newcastle, Institute of Health and Society, 21 Claremont Place, Newcastle upon Tyne, Tyne & Wear, UK, NE2 4AA.
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Fongwa MN, Evangelista LS, Hays RD, Martins DS, Elashoff D, Cowan MJ, Morisky DE. Adherence treatment factors in hypertensive African American women. Vasc Health Risk Manag 2008; 4:157-66. [PMID: 18629350 PMCID: PMC2464745 DOI: 10.2147/vhrm.2008.04.01.157] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hypertension among African American women is of epidemic proportions. Nonadherence to treatment contributes to uncontrolled blood pressure in this population. Factors associated with adherence to treatment in African American women are unknown. The purpose of this study was to identify factors associated with adherence to hypertension treatment in African American women. METHODS Five audio-taped focus groups were conducted with hypertensive African American women, 35 years and older receiving treatment for hypertension from an inner-city free clinic. All transcripts from the tapes were analyzed for content describing adherence to treatment factors. FINDINGS factors associated with adherence to treatment in hypertensive african american women were in three main categories including: beliefs about hypertension, facilitators of adherence to treatment, and barriers to adherence to treatment. IMPLICATIONS The study supports the need for education on managing hypertension and medication side effects, early screening for depression in hypertensive African Americans, development of culturally sensitive hypertension educational material, and formation of support groups for promoting adherence to treatment among African American women with hypertension.
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Affiliation(s)
- Marie N Fongwa
- University of California Los Angeles School of Nursing, Los Angeles, CA 90095-6917, USA.
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