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Telephone-based stress management to reduce blood pressure in Black women with hypertension in the Jackson Heart Study

Award Number: R01MD016402
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/07/2022
PERIOD OF PERFORMANCE END DATE: 11/30/2027

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Telephone-based stress management to reduce blood pressure in Black women with hypertension in the Jackson Heart Study - Modified Project Summary/Abstract Section Black women experience disproportionately high rates of hypertension compared to women of other racial and ethnic groups, and their blood pressure (BP) control rates are well below targets despite high levels of awareness and treatment. There is an urgent need for effective nonpharmacological strategies beyond lifestyle behavior change to improve hypertension and cardiovascular disease (CVD) outcomes in this understudied population. Chronic psychosocial stress is associated with hypertension and CVD. Black women may employ coping strategies (e.g., emotion suppression, self-care postponement) that increase vulnerability to stress. While many stressful events and circumstances cannot be avoided, adaptive coping can mitigate adverse effects of stress exposure. Mindfulness-based cognitive therapy (MBCT) is an evidence-based program that teaches meditation practices and cognitive strategies to reduce perceived stress and negative emotions. Qualitative research supports the cultural relevance of mindfulness interventions for Black women but clinical trial evidence in this population is limited. Further, the burdensome nature of traditional in-person MBCT poses a significant barrier to participation. We have adapted MBCT for delivery to small groups by telephone (MBCT-T) and our preliminary data support the feasibility, acceptability and effects of the intervention. We propose an RCT to evaluate effects of MBCT-T on BP and psychological outcomes in Black women with uncontrolled hypertension in the Jackson Heart Study (JHS) - a longitudinal cohort study designed to investigate the causes of CVD in Black adults. A sample of 300 female JHS participants with uncontrolled hypertension will be enrolled and randomized to MBCT-T or telephone-based support groups (TSG), an active comparison condition. Both programs involve 8 weekly group-based phone sessions. The primary outcome is home BP, a better predictor of CVD risk than clinic BP, measured for 7 days at baseline and 3- and 6-month follow-up visits with validated wireless devices. Secondary outcomes are perceived stress and depressive symptoms. Measures of chronic stress, coping, resilience and potential psychological, social and behavioral mediators of intervention effects will be assessed. Data from the three prior JHS exams and 20 years of annual follow-up assessments will also be used to characterize long-term levels of psychosocial factors that may help to explain variability in treatment response. The specific aims are to: (1) Test the hypothesis that MBCT-T will be associated with greater 6-month reductions in systolic BP vs. TSG; (2) Test the hypothesis that MBCT-T will be associated with greater 6-month reductions in perceived stress and depressive symptoms vs. TSG; and (3) Explore potential mediators and moderators of intervention effects on BP and secondary outcomes. Findings will advance understanding of stress, coping and effects of stress management in Black women. If effective, this scalable psychosocial intervention has the potential to positively impact hypertension and other health outcomes among Black women in the JHS cohort and beyond.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $716,297 )
2026	2026	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	4	2/23/2026	NON-COMPETING CONTINUATION	$716,297
														Subtotal = $716,297

Issue Date FY: 2025 ( Subtotal = $728,691 )
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	3	11/10/2024	NON-COMPETING CONTINUATION	$655,822
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	003	3	9/18/2025	NON-COMPETING CONTINUATION	$0
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	002	3	4/21/2025	NON-COMPETING CONTINUATION	$72,869
2025	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	2	10/10/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $728,691

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	2	2/21/2024	NON-COMPETING CONTINUATION	$0
2024	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	2	1/24/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $735,477 )
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	2	3/23/2023	NON-COMPETING CONTINUATION	$735,477
2023	2022	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	1	3/23/2023	NEW	$0
														Subtotal = $735,477

Issue Date FY: 2022 ( Subtotal = $787,864 )
2022	2022	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	1	8/7/2022	NEW	$787,864
														Subtotal = $787,864

Grand Total All Awards = $2,968,329

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Telephone-based stress management to reduce blood pressure in Black women with hypertension in the Jackson Heart Study

Award Number: R01MD016402

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/07/2022

PERIOD OF PERFORMANCE END DATE: 11/30/2027

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