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Introduction: Black women have the highest prevalence of hypertension (HTN) compared to other racial/ethnic groups. Depression impacts women on a 2:1 ratio and increases cardiovascular risk. Black women are less likely to receive evidence-based care for depression and face barriers to engaging in healthy behaviors. In the current descriptive analysis, we examined baseline data from an ongoing pilot randomized controlled trial aimed to assess the efficacy of a group self-management program to decrease depression and HTN risk. Hypotheses: We assessed the hypothesis that a well-characterized sample of 30 depressed Black women would have high levels of physical and psychosocial risk factors for cardiovascular disease, low levels of treatment engagement, and that depression severity would correlate with experience of discrimination, stress, and perceived lack of social support. Methods: Inclusion criteria were Black women between the age of 18-49 with moderate depression (PHQ-9 of ≥10) and at least one risk factor for HTN. Social determinants of health (SDOH), discrimination, stress, and social support were assessed using validated measures. Results: The sample consisted of 30 Black females; mean age=34.27, SD= 8.60, and mean years of education=13.97, SD=1.79. Mean depression=15.10, SD=3.16, 33.33% endorsed thoughts of self-harm, and 36.67% reported currently receiving treatment for depression. Of those, 72.7% were in therapy and 54.5% were taking medication. Forty percent reported a history of physical abuse and 36.7% reported a history of sexual abuse. Salient cardiovascular risk factors included mean BMI=37.47, SD=5.84 (29/30 met BMI>30 criteria), 26.67% smoker, 6% diabetes, 13% high cholesterol, and 46.67% other chronic health conditions. Mean discrimination score was 27.23, SD=10.96 indicating moderate exposure to discrimination and 75% identified race as the main source of discrimination. Additionally, 26.67% scored above the threshold on violence as measured by a SDOH screener and perceived stress averaged in the moderate range. Depression severity was significantly correlated with discrimination ( r =.43, p <.05), stress, ( r =.55, p <.01) and trended with social support ( r =-.39, p =.076). Conclusion: In conclusion, given the high rates of CVD risk factors, multiple psychosocial stressors, and low rates of treatment engagement, to improve cardiovascular health in Black women, we must be aware of and address a more comprehensive set of socio-emotional risk factors. Self-management interventions that simultaneously provide social support, address mental health needs, and are led by peers are likely to increase engagement and improve health outcomes.
Church et al. (Tue,) studied this question.