Abstract P251: Using Art to Mitigate Psychosocial Stress and Blood Pressure Among Black Women: A Pilot Trial

Abstract

Background: Black women demonstrate higher levels of stress over the life course compared to Black men, White men, and White women, which may help to explain their higher cardiovascular disease (CVD) morbidity and mortality. Despite implications for primary and secondary CVD prevention and racial disparities, few interventions have targeted psychosocial stress to improve blood pressure (BP) levels among Black women. Objective: To test whether a theory-driven, culturally tailored, community intervention focused on the stress experiences of Black women improves psychological outcomes and BP levels. Methods: The “Art for Hearts” pilot trial sought to examine the feasibility, acceptability, and preliminary efficacy of a novel intervention encouraging creative self-expression. This individual level, single-arm pilot trial recruited self-identified Black women ≥18 years. Women participated in an 8-week program, including 4 art sessions with a community artist (a self-identified Black woman) accompanied by a moderated focus group discussion and 4 heart health education sessions (facilitated by a Black woman researcher) on home BP monitoring, stress management techniques, diet/physical activity, and patient-clinician communication. All sessions were conducted in-person in a community space. Participants completed a survey including self-rated stress (scale of 0 to 7), perceived stress (PSS-10), depressive symptoms (PHQ-8), and anxiety symptoms (GAD-7) at baseline and 8 weeks. BP was measured by a trained assessor at baseline and 8 weeks as well as before and after each session. We examined within-participant changes in psychological measures as well as mean systolic and diastolic BP from baseline to 8 weeks. Results: The study included 18 Black women with a mean age of 44.1 (SD=15.4) years. Women were highly educated (36.8% with a graduate/professional degree) and 11.1% earned an income of ≥$100,000. Mean systolic BP was 114 mmHg and mean diastolic BP was 66 mmHg at baseline. From baseline to 8 weeks, self-rated stress level decreased by 1-point (from 4.36 to 3.18; p=0.005) (scale range: 0 -7). Perceived stress (-1.08; p=0.58) and anxiety (-1.33; p=0.09) decreased from baseline to 8 weeks; however, these changes did not achieve statistical significance. Depressive symptoms significantly improved from baseline to 8 weeks (19.13 to 13.38; p=0.044). There were no differences in systolic or diastolic BP from baseline to follow-up. The intervention was deemed feasible and acceptable with an attendance rate of >80%; participants expressed high overall satisfaction with the intervention. Conclusion: A tailored 8-week pilot intervention using painting self-expression demonstrated feasibility, acceptability, and preliminary efficacy for improving self-rated stress and depressive symptoms. No effects were demonstrated on BP in this sample.