Reducing Health Disparities among African American Women: A Mobile Cognitive Behavioral Stress Management Intervention

PROJECT SUMMARY ABSTRACTThe unjust socialeconomicand environmental conditions that all African Americans face throughout their lives leads to pervasive health disparitiesSubstandard medical care due to systematic bias in the healthcare system and a substantial wealth gap between Black and White households all lead to poorer healthAnd yetthe association between race and health persists even when controlling for these social determinantsOne reason for thisstressAfrican Americans experience more stress than their White peers and have fewer resources to manage these stressorsThe story is even more dire for African American women who simultaneously face both racial discrimination and sexismIndeedthe experience of gendered racial discrimination is nearly ubiquitous for Black women at all socioeconomic levelsIt is also a distinct form of stress with unique outcomes compared to other non race or gender related stressorsFinallystress has clear downstream effects on healthboth through physiological processes and through health behaviorsWhile several investigators have specifically developed stress management interventions for African Americansmuch more needs to be doneCulturally sensitive behavioral health programs are more effective than generic programs for minority groupsBecause stress significantly drives health disparities over and above other social determinantsdeveloping effective stress management programs for African American women is vital to closing this gapOne cost effective solution is mHealthNinety eight percent of African Americans own a mobile phoneMost are smartphonesAnd smartphone ownership is higher among Black women than White womenTo our knowledgeno mobile cognitive behavioral stress management intervention has been developed for African American women to manage racial and nonracial sources of stressWe intend to fill this voidWhen completedsupportive texts will inspiremotivateand affirm the life experiences of African American womenEducational texts will increase knowledgedevelop skillsand reduce barriers to adaptive copingA library of individually tailored videos will be delivered to each user depending on a theory based assessment of stressincluding perceived discriminationand copingAll mobile web content will be effortlessly and efficiently accessed via touch based links embedded within text messagesEight healthcare staff members will be recruited for a focus group discussion to help shape the proposed interventionSimilarlyAfrican American women will be recruited for predevelopment focus group discussionsWhen the prototype is completedthetarget end users will return for usability testingThe usability test will include a series of tasks intended to highlight the different features of the proposed interventionThree usability metrics will be assessedefficiencyaccuracyand subjective satisfaction PROJECT NARRATIVE This project aims to develop a mobile phone based stress management program for African American women to manage stress caused by discrimination and non discrimination experiencesBecause most Black women have smartphonesthis program can be easily distributed at a lower costFor African American womenthe skills contained in this program will help them reduce stress and the negative impact that stress has on health