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Study Shows that Culturally Appropriate Storytelling May Help Control Blood Pressure
1-18-11
A new study shows that culturally appropriate storytelling may help control blood pressure in African Americans with hypertension, according to an article published in the January 18 issue of the Annals of Internal Medicine.
“Perhaps most importantly, the study shows that improvements in blood pressure control may be relatively simple to achieve with the aid of locally-produced videos,” says lead investigator Thomas Houston, MD, of the University of Massachusetts. “What’s more, the intervention the researchers designed is simple enough to be repeated in clinics nationwide.”
Controlling blood pressure is difficult because it requires strict adherence to a treatment plan that may include medication, dietary restrictions, and regular doctor visits. For African American patients, managing hypertension may be made more challenging by social and cultural barriers within the health care system. While the medical community recognizes and has tried to bridge racial and ethnic gaps in blood pressure control, few culturally relevant treatment interventions for minority patients currently exist. Emerging evidence suggests that storytelling may be a powerful tool to communicate evidence-based disease management choices in ways that are culturally appropriate. Despite their promise, storytelling interventions remain largely untested in rigorous clinical studies.
In the present study, researchers at Cooper Green Mercy Hospital and the University of Alabama at Birmingham randomly assigned 299 low-income, low-literacy African Americans with hypertension -- a group with demonstrated disparities in cardiovascular care, illness and death -- to receive either standard care or to watch three videos that offered first-person accounts and advice from local patients with hypertension as well as instructional material about making lifestyle changes to improve health. The study found that watching the DVDs resulted in behavior changes that led to a 6mmHg reduction in systolic blood pressure for those with uncontrolled hypertension over the control group. Research shows that reducing systolic blood pressure by two to three mmHg may save thousands of lives in the United States each year.
“This study shows the power of storytelling and how important it is to explain health information to patients in ways that are meaningful to them in their daily lives,” says Marshall Chin, MD, Director of Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation and the University of Chicago
Funding for the study was provided by Finding Answers, which evaluates the impact of interventions aimed at closing racial and ethnic gaps in care, with a particular focus on cardiovascular disease, depression and diabetes. These are conditions where evidence of racial and ethnic disparities in the quality of care is strong and the recommended standards of care are clear. Studies like that at Cooper Green Mercy Hospital and the University of Alabama at Birmingham are helping to identify successful approaches to reducing racial and ethnic disparities that have potential to be replicated and sustained in communities throughout the United States.
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Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation at the University of Chicago, awards and manages research grants totaling $8 million to health care organizations implementing interventions aimed at reducing disparities. The funds are used to evaluate the interventions and their potential for real-world implementation. This initiative encourages health plans, hospitals, and community clinics to focus on racial and ethnic disparities as a priority in their quality improvement agendas. To learn more about Finding Answers, visit www.SolvingDisparities.org.
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.
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