Proof of Concept Trial of a Mindful Walking Intervention for Black Women with Hypertension

ABSTRACT Hypertension disproportionately affects Black women and is a key risk factor for cardiovascular disease, a leading cause of death. As many as 39.9% of Black women have hypertension compared to Asian women (21.9%), Hispanic women (28%), and White women (25.6%). Among women with hypertension, Black women are 2.3 times more likely than white women to have uncontrolled blood pressure (BP). Physical activity can reduce hypertension risk and incidence, but rates are low among Black women. The vast majority of Black women (83.3%), are not meeting the national guidelines for physical activity. Stress is known as a key risk factor for hypertension as well as a major barrier to physical activity among Black women. To address hypertension and physical activity disparities among Black women, we propose a technology-delivered mindful walking intervention to reduce stress, increase PA, and ultimately reduce blood pressure in Black women with hypertension. We will leverage culturally-relevant frameworks on stress among Black women such as the Superwoman Schema to understand the role of stress on health outcomes in Black women to tailor the intervention. We will conduct focus groups with N=30 Black women with hypertension who are insufficiently active to gather insights about 1) barriers and facilitators to engaging in physical activity, 2) views of the Superwoman Schema, and 3) perspectives on a remotely delivered mindful walking intervention, including the modality, goals, walking pad, and content. Using the ORBIT model for intervention design, we will then develop and test the intervention in a 1-arm proof of concept study. Findings will inform the development of the intervention in preparation for an efficacy trial. We will enroll N=30 Black women into a 12-week Facebook-delivered mindful walking intervention. Feasibility outcomes will include recruitment, retention, engagement, and acceptability. Following this proof-of-concept test, we will conduct post intervention focus groups with participants to further refine the intervention. Building on Dr. Kalinowski’s prior pilot work on mindfulness and hypertension in Black women, this study will provide her with training in designing, developing, and implementing technology-delivered physical activity interventions to reduce CVD risk among Black women. This project contributes to Dr. Kalinowski’s long-term goal of designing technology-delivered physical activity interventions that can be leveraged to reduce CVD burden among Black women. Dr. Kalinowski has access to a rich research environment at the University of Connecticut along with expert mentors who are dedicated to her training and long-term development as an independent researcher.