Leveraging Delivery of Blood Pressure Control Interventions among Low-income African American Adults: Opportunities to Increase Social Support and Produce Family-level Behavior Change

Abstract

Purpose: Few family-oriented cardiovas­cular risk reduction interventions exist that leverage the home environment to produce health behavior change among multiple family members. We identified opportu­nities to adapt disease self-management interventions included in a blood pressure control comparative effectiveness trial for hypertensive African American adults to ad­dress family-level factors.Methods: We conducted and analyzed semi-structured interviews with five inter­vention study staff (all study intervention­ists and the study coordinator) between December 2016 and January 2017 and with 11 study participants between Septem­ber and November 2015.1 All study staff involved with intervention delivery and co­ordination were interviewed. We sampled adult participants from the parent study, and we analyzed interviews that were originally obtained as part of a previous study based on their status as a caregiver of an adoles­cent family member.1Results: Thematic analysis identified family influences on disease management and the importance of relationships between index patients and family members, between in­dex patients and study peers, and between index patients and study staff through study participation to understand social effects on healthy behaviors. We identified four themes: 1) the role of family in health behavior change; 2) the impact of family dynamics on health behaviors; 3) building peer relationships through intervention par­ticipation; and 4) study staff role conflict.Conclusions: These findings inform development of family-oriented interven­tions to improve health behaviors among African American index patients at high risk for cardiovascular disease and their family members.Ethn Dis. 2019;29(4):549-558; doi:10.18865/ed.29.4.549