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Show Blood pressure changes during a 12 month wellness coaching program among Utah women of color Hannah Wright, Sara E. Simonsen, Grant Sunada, Lisa Gren, Heather Coulter, Patricia Eisenman, Stephen C. Alder, Louisa A. Stark, Brenda Ralls, Leanne Johnston & Kathleen Digre for the Coalition for a Healthier Community for Utah Women and Girls INTRODUCTION & BACKGROUND • Hypertension is a risk factor for coronary heart disease and stroke, occurring at higher rates in women of color than in non-Hispanic Whites. • Reducing blood pressure in high risk groups is a challenging public health issue. • The Coalition for a Healthier Community for Utah Women and Girls (CHC-UWAG) utilized community based participatory research to design and implement a 12month wellness coaching program for African (primarily immigrants), African American, American Indian, Latina, and Pacific Islander women. METHODS • Community wellness coaches (CWC) were recruited from 5 communities and trained in Motivational Interviewing and standardized, best practices for measuring blood pressures • CWCs enrolled women into a 12-month coaching program focused on obesityrelated health behaviors and randomized to receive monthly or quarterly coaching • Women set personal health behavior change goals with the CWC • If pre-hypertensive or hypertensive, the women were referred for care • The CWC averaged 3 recorded blood pressure measurements for each participant at baseline, 4, 8, and 12-months. • Paired t-test were used to evaluate differences in mean systolic & diastolic blood pressure between baseline and 12-months across all women and by community • Blood pressure levels as defined by the CDC were utilized: o Pre-hypertensive - 120-149 mmHg for systolic and 80-89 mmHg for diastolic o Hypertensive - ≥140 mmHg for systolic and ≥90 mmHg for diastolic RESULTS • • At the beginning of the program, 496 women were enrolled: o 381 completed measurements for both baseline and 12 month blood pressures o 17 who were pregnant during the study were not included in the final analysis • For participants classified as hypertensive at baseline, there was a statistically significant difference between baseline and 12-month average blood pressures for both systolic and diastolic (both p<0.001) • The median change for hypertensive women was 147.9 to 133.5 mmHG systolic and 96.3 to 83.3 mmHG for diastolic • The results for pre-hypertensives were similar with for systolic (p=0.002) and diastolic (p=0.01) 60% 50% 40% • 30% The results for pre-hypertensive were similar with for systolic *(p=0.002) and diastolic (p=0.01) 20% 10% • Assess the impact of a 12-month wellness coaching program on participants' blood pressure. • Stratify data by participant group to evaluate whether specific groups experienced significant changes in blood pressure between baseline and 12 months. Baseline Hypertensive and Pre-Hypertensive Women by Group Hispanic/ Latina American Indian/ Alaskan Native Pacific Islander • • • • In our study, we did find that wellness coaching may be an effective intervention to help women of color lower their blood pressures. Both hypertensive and pre-hypertensive women saw statistically significant decreases in their systolic and diastolic blood pressures. By communities of women, there were two groups that experienced statistically significant decreases in both their systolic and diastolic blood pressures More research is needed to assess the effects of wellness coaching on decreasing blood pressure, but the results from this diverse sample are promising. Wellness coaching should be considered as an additional way to help women of color decrease their blood pressures and reduce their risk for coronary heart disease and stroke Hypertensive at Baseline Hypertensive at 12 Months Prehypertensive at Baseline Pre-hypertensive at 12 Months CONCLUSIONS • • • • • 40% African American There was also a statistically significant decrease in blood pressure for women in the Latina (p<0.05 for both systolic and diastolic) and Pacific Islander (p<0.001 for both systolic and diastolic) communities 60% 50% African (Immigrant) • • OBJECTIVES Changes in Blood Pressure by Group 70% 0% RESULTS Urban Indian Center of Salt Lake community wellness coach and study participant When stratified by community, there were statistically significant decreases in both systolic and diastolic blood pressure for Hispanic/Latina women (p<0.05) and Pacific Islander women (p<0.001) There were not statistically significant decreases in other groups Community wellness coaching may be an effective intervention to address pre-hypertension and hypertension among women of color Hypertensive and pre-hypertensive women had statistically significant decreases in both systolic and diastolic blood pressure As part of their health goals, the women in this study made behavioral changes such as increasing fruit and vegetable intake, decreasing soda consumption, and increasing physical activity which may have helped to improve their blood pressure Those found to be pre-hypertensive and hypertensive were referred for care. Because of this, it is difficult to discern the impact of health behavior change versus referral care on decreasing blood pressure More research is needed to understand how wellness coaching impacts blood pressure in under-served communities; however, the results from this diverse sample are promising. Wellness coaching should be considered as an additional way to help women of color decrease their blood pressures and reduce their risk for coronary heart disease and stroke FUNDING 30% 20% DHHS Office on Women's Health \\ 10% 0% CHC-UWAG community wellness coaches African (immigrant) African American Hypertensive at Baseline Latina American Indian Prehypertensive at Baseline Pacific Islander grant 1CCEWH111018-01-00 University of Utah Center of Excellence in Women's Health Center for Clinical and Translational Science - Collaboration and Engagement Team \\ |
