Reducing Health Disparities among African American Women: A Mobile Cognitive Behavioral Stress Management Intervention

减少非裔美国女性的健康差异：移动认知行为压力管理干预措施

• 批准号: 10263380
• 负责人: DOUGLAS W BILLINGS
• 金额: $ 62.51万
• 依托单位: ISA ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-02 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263380
• 关键词: Affective; African American; Behavioral; Benchmarking; Biological; Car Phone; Cellular Phone; Cognitive; Comprehension; Computers; Counseling; Development; Discrimination; Economics; Effectiveness; Effectiveness of Interventions; Emotional; Face; Family; Gender; Health; Health behavior; Healthcare; Household; Human; Individual; Internet; Intervention; Knowledge; Lead; Learning; Libraries; Life Experience; Link; Longevity; Measures; Medical; Meta-Analysis; Minority Groups; Morbidity - disease rate; Multimedia; Not Hispanic or Latino; Outcome; Ownership; Participant; Patient Self-Report; Patients; Personal Satisfaction; Phase; Physiological; Procedures; Public Health; Race; Randomized; Research; Risk Factors; Services; Sex Bias; Socioeconomic Status; Stress; Techniques; Text Messaging; Touch sensation; Underserved Population; Woman; Work; base; behavioral health; biological adaptation to stress; black women; care providers; care seeking; community based care; coping; cost; cost effective; design; effective intervention; experience; follow-up; group intervention; health disparity; high school; mHealth; mortality; peer; programs; prototype; racial discrimination; racial identity; response; skills; social; social determinants; social health determinants; socioeconomics; stress management; stressor; therapy design; uptake

PROJECT SUMMARY/ABSTRACT The unjust social, economic, and environmental conditions that African Americans face throughout their lives lead to pervasive health disparities. These disparities are driven by healthcare differences, where White patients are more likely to receive medical procedures when they seek care, and it is of higher quality, than what is received by African Americans. They are driven by economic differences, where the net worth of non- Hispanic White households is $132,000 while it is only $9,000 for Black households. Those with less financial wealth have poorer health as compared to those with higher socioeconomic status. And yet, even when controlling for these two important social determinants of health, race still predicts morbidity and mortality. What can account for this? Stress. African Americans experience more stress than their White peers. The story is even more dire for African American women who simultaneously face both racial discrimination and sexism. Indeed, gendered racial discrimination is nearly ubiquitous for Black women at all socioeconomic levels. It is also a distinct form of stress, with unique outcomes compared to other non-race-or-gender-related stressors. Finally, stress has clear downstream negative effects on health. To our knowledge, there is no mobile cognitive–behavioral stress management intervention (m-CBSMi) on the market that is designed to help African American women manage racial and nonracial daily stress. We intend to fill this void. Using proven CBSMi techniques, Black women will learn how to manage their stress through text messages and integrated mobile web content. Supportive texts will inspire, motivate, and affirm the life experiences of African American women. Educational texts will increase knowledge, develop skills, and reduce barriers to adaptive coping. A library of individually tailored videos will be delivered to each user based on her personal experiences. All mobile web content will be accessible only through touch-based links embedded within text messages, making it easy and effortless to view this material. In Phase I, a prototype m-CBSMi was developed. This development was informed by formative research with community-based care providers plus 24 African American women across the lifespan. The results of Phase I strongly support the feasibility and potential effectiveness of the intervention, far exceeding the benchmarks established in the Phase I proposal. During Phase II we will complete development of the m-CBSMi for African American women. Then, in partnership with Family and Medical Counseling Service, we will examine the effectiveness of the m-CBSMi to reduce stress among African American women. Participants will be randomly assigned to either the intervention condition or to a matched control condition. Secondary measures will assess coping, well-being, subjective health, gendered racial identity, and knowledge.

项目概要/摘要 非裔美国人一生中面临的不公正的社会、经济和环境条件 生活导致普遍的健康差异，这些差异是由医疗保健差异造成的，其中怀特。 患者在寻求护理时更有可能接受医疗程序，而且医疗程序的质量比 非裔美国人所接受的东西是由经济差异驱动的，其中非裔美国人的净资产 西班牙裔白人家庭为 132,000 美元，而经济状况较差的黑人家庭仅为 9,000 美元。 然而，与社会经济地位较高的人相比，富有的人的健康状况较差。 在控制了这两个重要的健康社会决定因素后，种族仍然可以预测发病率和死亡率。 造成这种现象的原因是什么？非裔美国人比白人同龄人承受的压力更大。 对于同时面临种族歧视和 事实上，性别种族歧视对于黑人女性来说几乎无处不在。 它也是一种独特的压力形式，与其他与种族或性别无关的压力相比，具有独特的结果。 最后，压力对健康有明显的下游负面影响。 据我们所知，目前还没有移动认知行为压力管理干预（m-CBSMi） 该市场旨在帮助非裔美国女性应对种族和非种族的日常压力。 打算利用经过验证的 CBSMi 技术来填补这一空白，黑人女性将学习如何管理她们的压力。 通过短信和集成的移动网络内容，支持性文本将激发、激励和肯定。 非洲裔美国妇女的生活经历将增加知识、发展技能和 减少适应性应对的障碍。将向每个用户提供单独定制的视频库。 根据她的个人经历，所有移动网络内容都只能通过基于触摸的链接访问。 嵌入短信中，使您可以轻松轻松地查看该材料。 在第一阶段，开发了 m-CBSMi 原型。这一发展是基于形成性研究。 与社区护理提供者以及 24 名非裔美国女性的整个生命周期的结果。 第一阶段强烈支持干预措施的可行性和潜在有效性，远远超过 第一阶段提案中制定的基准。 在第二阶段，我们将完成针对非裔美国女性的 m-CBSMi 的开发。 与家庭和医疗咨询服务机构合作，我们将检查 m-CBSMi 的有效性 减轻非裔美国女性的压力 参与者将被随机分配到其中任一组。 干预条件或匹配的控制条件将评估应对、幸福感、 健康、性别种族主观认同和知识。