Building a Multidisciplinary Research Program to Address Hypertension Disparities:Exploring the Neurocognitive Mechanisms of a Self-Management Intervention for African American Women with Hypertension

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PROJECT ABSTRACT With a continued increased in the diagnosis and prevalence of hypertension among African American women, this group is particularly vulnerable to stroke, end-stage renal disease, and premature death. Although there are interventions available to help patients manage chronic disease, there is significant variability in blood pressure control among African American women. Current approaches to aid patients in making lifestyle changes have primarily been “one size fits all” methods. Self-management behaviors require cognitive effort – for planning and goal-setting, these factors are associated with distinct patterns of brain activity, referred to as “neuroprocessing.” The relationship between neuroprocessing and self-management behavior is poorly understood. Findings from our pilot studies show a large correlation between health information behavior (information sharing) and activation in the default mode network (comprised of the medial parietal and prefrontal cortices, and temporo-parietal junctions and responsible for social and emotional modes of thought) and the ventromedial prefrontal cortex (shown to mediate links between social connection and health). A better understanding of how brain activity (ability to differentiate between neurological prompts) changes in response to our hypertension education programs will improve the precision and tailoring of self-management interventions. The objective of this project is to develop and pilot test a newly designed, health information behavior enhanced intervention to improve self-management of hypertension in African American women. Using functional magnetic resonance imaging, or fMRI, we will examine brain activity (default mode network vs. task positive network) in response to video prompts. We will assess the influence of the intervention on neurocognitive processes associated with self-management in a subset of the sample to explore the neurobiological mechanisms underlying the intervention. This work will contribute to the reduction of the tremendous health disparities affecting African American women. The findings will be used to support future studies examining the effects of our information sharing intervention in a larger sample of African American women with hypertension. Dr. Jones's program of research is focused on designing and testing self-management interventions to improve blood pressure control among African American women, as well as detailing the individual neuroprocessing profiles associated with successful response to such interventions. The training and mentoring plan will promote development in three areas: 1) intervention design and testing, 2) cognitive neuroscience, and 3) grantsmanship. This multidisciplinary team of experienced mentors and advisors will oversee a range of training and research activities in these areas to ensure Dr. Jones's future success. The exceptional resources of a top university and a mentoring team with proven success in developing junior faculty in these topic areas make the University of Michigan an ideal environment for Dr. Jones's project.