Addressing Depression for African American Adults with Hypertension: Applying Community-Engaged Implementation Science

PROJECT SUMMARY/ABSTRACT At least 1 in 4 adults with hypertension also has depression. The rate of depression is even higher among African American adults compared to white adults with hypertension. Depression is associated with worse blood pressure control, poorer adherence to antihypertensive medications, and ultimately poorer cardiovascular disease outcomes. Thus, treating depression has great potential to improve hypertension outcomes and address cardiovascular disease disparities among African Americans. An important limitation of available evidence-based interventions is that they are not adapted for the context in which they are implemented, thereby reducing their effectiveness and reach. This project proposes to: 1) use health informatics to characterize the contextual factors that influence depression, hypertension, and their association among African Americans on the South Side of Chicago, a community with significant cardiovascular disease disparities; 2) collaborate with community partners to select an evidence-based, culturally appropriate intervention for depression and adapt it for the implementation context; and 3) pilot the adapted intervention among African American adults with depression and hypertension on the South Side of Chicago. By collaborating closely with community partners to adapt the intervention for the context, the resulting implementation protocol holds great potential to extend the reach of and engagement in the intervention. The implementation and effectiveness results will increase specificity and competitiveness of a subsequent grant proposal to conduct a full-scale trial. Dr. Allison Carroll’s overarching career goal is to implement evidence-based behavioral interventions to address cardiovascular disease disparities. Through the proposed research project, training plan, and mentorship, Dr. Carroll will expand her knowledge and skills related to implementation science methodology, particularly focused on blood pressure control; behavioral interventions to address health disparities; community- engaged research; and health informatics. Dr. Carroll’s proposed research aims and training goals are well- aligned with the priorities of the National Heart, Lung, and Blood Institute as well as the Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. The K23 Mentored Patient- Oriented Research Career Development Award will provide Dr. Carroll with the necessary tools to become a successful independent investigator.