Interventions
depression, hypertension, cardiovascular disease, anxiety
CARDIOVASCULAR DISEASE, DISEASE, SECONDARY, HYPERTENSION, CHRONIC DISEASE
The PTSC is a multifaceted, theory-driven, and community-based intervention characterized by didactic training delivered by trained African American facilitators, content experts (for hypertension, stress management, fitness, and nutrition), and intensive peer-based social support. Marilyn Gaston (a physician) and Gayle Porter (a clinical psychologist) established The Gaston and Porter Health Improvement Center, Inc. (GPHIC), as a National Training Institute. The GPHIC trained PTSC facilitators on cardiovascular conditions, group facilitation and leadership, and on cultural beliefs undergirding self-management of chronic conditions. The facilitators were PTSC program graduates who resided in the communities the program serves [PTSC addresses three key modifiable health risk factors for chronic disease: unmanaged stress, physical inactivity, and unhealthy nutritional choices. It addresses additional risk factors that contribute to unhealthy lifestyles: lack of knowledge or misinformation about major illnesses, including hypertension; and it also aims to encourage mid-life African American women to prioritize their health and take proactive steps of primary and secondary prevention to manage their health and health care outcomes. PTSC is structured to support African American women to deepen their grasp of the requisite information, motivation, skills, and consultative support to improve and maintain their health. They are assisted in developing habits of primary and secondary prevention.Those assigned to the PTSC intervention group attended a two-hour per week facilitator-led Sister Circle for 13 weeks. Sessions featured an educational presentation provided by facilitators or experts on the topic of the week. Facilitators discussed the topics in relation to hypertension and cardiovascular disease and included overall disease prevention, stress management, mental health (depression and anxiety), self-esteem, fitness, nutrition, psychosocial well-being, and effective communication with health care team members. Following the presentations, facilitators guided discussion with all participants, including role playing to model how best to navigate circumstances that could threaten their ability to adopt the recommended lifestyle change (for example, talking with their family members about the changes they are making because of the PTSC, or discussing with their physician and asking health-related questions).