What is the clinical evidence from this study?

Study design: Other. Population: Black women aged 35-50 with elevated blood pressure (systolic ≥140 mm Hg) in a safety-net health system (n=24). Intervention: Qualitative focus group participation. Primary outcome: Exploration of lived experiences of stress and coping among black women in early midlife with elevated blood pressure.

What question did this study set out to answer?

To explore the experiences of stress and coping among black women in early midlife with hypertension to inform intervention development.

February 28, 2026Open Access

Exploring stress and coping among black women in early midlife with elevated blood pressure in a safety-net health system: a qualitative focus group protocol

Key Result

This study protocol describes focus groups exploring stress and coping experiences among 24 Black women aged 35-50 with elevated blood pressure to inform a culturally relevant stress management intervention.

Key Points

To explore the experiences of stress and coping among black women in early midlife with hypertension to inform intervention development.
Conduct one-time semistructured focus groups with black women aged 35-50 with elevated blood pressure.
Recruit participants from a large safety-net health system.
Analyze data using constructivist grounded theory and inductive theme development.
Utilize AI to assist in theme exploration alongside human analysis.
Participants reported high levels of stress linked to social determinants of health.
Emerging themes related to coping strategies and cultural factors were identified.
Findings will guide the design of a tailored stress management intervention.

Structured PICO

Population

Target of 24 Black women aged 35-50, fluent in English, with at least one electronic medical record in the past 12 months indicating a systolic blood pressure of ≥140 mm Hg, recruited from a single safety-net health system.

Outcome

Lived experiences of stress and coping, and identification of individual and contextual factors shaping these experiences to inform codesign of a stress management intervention.

This protocol describes a qualitative study exploring stress and coping among Black women in early midlife with elevated blood pressure to inform the development of a culturally relevant stress management intervention.

Limitations

Findings will be context specific and may not be generalisable beyond black women in early midlife with elevated blood pressure.
Recruitment from a single safety-net health system may limit transferability.
AI-assisted qualitative analysis is limited by lack of contextual understanding and requires oversight.

Abstract

Introduction Black women in early midlife experience disproportionate exposure to stress and elevated cardiovascular risk, including hypertension. Despite this, few stress management interventions are designed with and for this population. This study aims to explore the lived experiences of stress and coping among black women in early midlife with elevated blood pressure to inform the codesign of a culturally relevant, multilevel stress management intervention. Methods and analysis We will conduct one-time, semistructured focus groups with black women aged 35–50 who have elevated blood pressure, recruited from a large safety-net health system. Data will be analysed using a constructivist grounded theory approach, with inductive theme development supported by line-by-line, focused and theoretical coding. The Social Determinants of Cardiovascular Disease framework will serve as a sensitising guide to multilevel contextual factors rather than a prescriptive coding structure. An artificial intelligence (AI)-assisted analytic component will complement human-led analysis by supporting preliminary theme exploration and enhancing transparency. Ethics and dissemination Approved by the Indiana University Institutional Review Board (Protocol #21785). All participants will provide written informed consent. Findings will be shared via peer-reviewed publications, conference presentations and lay summaries for stakeholders.

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