PROJECT SUMMARY
No demographic group is more at risk for the double jeopardy of caregiving stress and hypertension than
African American women caring for a family member with Alzheimer’s disease and related dementias (ADRD).
Both situations lead to reduced quality of life and cardiovascular disease—a complication of uncontrolled
hypertension.1 Maintaining the health of these caregivers is critical to support the well-being of the care
recipients. Although some multi-component interventions have addressed ADRD caregiver's stress and quality
of life, 2,3 gaps remain in targeting interventions to address the complexity of chronic caregiving stress and
hypertension self-care in African American women. This pilot study builds on our earlier work which showed
that stress, blood pressure knowledge, and complex diet information deficits all interfered with older African
American women’s hypertension self-care.4-7 Lifestyle changes (stress management, reducing sodium, eating
fruits/vegetables, and physical activity) are effective in managing hypertension. Our Stage I pilot study is based
on the scientific rationale that we can promote these lifestyle changes by addressing stress reactivity/stress
resilience, the psychological and physiological response of the body to stress, as the underlying mechanism to
facilitate behavioral change. In this way we can improve health outcomes (caregiver stress, quality of life,
cardiovascular disease risk). A small-scale two-group randomized controlled (RCT) pilot study of 28 African
American female caregivers, age 40 and older with hypertension, will be conducted. We will determine the
feasibility and acceptability of Mindfulness in Motion (MIM) plus the Dietary Approaches to Stop Hypertension
(DASH).8 Participants will be randomized to either the MIM DASH7 intervention or the Alzheimer’s Association
Caregiver Training (attention control) in 8 weekly, 1-hour group sessions via telehealth (video and telephone
access). After completion of the intervention, both groups will receive four bi-monthly follow-up calls over the
12 months. To our knowledge, this is the first study that a) systematically employs one of the Science of
Behavioral Change key mechanisms underlying successful adoption of health behaviors—stress
reactivity/stress resilience9 and b) focuses solely on African American female caregivers of people living with
dementia. The aims are: a) determine the feasibility and acceptability of MIM DASH and Caregiver Training for
African American female caregivers with hypertension; b) explore the impact of MIM DASH as compared to
Caregiving Training on caregiver stress and quality of life; quality of life; and c) investigate the potential
mediation effects of stress reactivity/stress resilience between MIM DASH or Caregiver Training and self-care
behaviors. This pilot will make a substantive contribution to the science of behavior change by identifying basic
mechanisms, in the adoption of healthy behaviors that can be used to implement self-care interventions to
reduce health disparities in African Americans. Study findings will inform the infrastructure for a larger trial.
