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

项目总结/摘要 非裔美国人在整个非洲大陆所面临的不公正的社会、经济和环境条件， 生活导致普遍的健康差距。这些差异是由医疗保健差异造成的，其中白色 病人在寻求护理时更有可能接受医疗程序，而且质量更高， 非裔美国人的感受它们是由经济差异驱动的，非- 西班牙裔白色家庭为132,000美元，而黑人家庭仅为9,000美元。那些经济状况较差的人 与社会经济地位较高的人相比，富裕的人的健康状况较差。然而，即使 在控制了这两个重要的健康社会决定因素之后，种族仍然可以预测发病率和死亡率。 这是什么原因呢？应力非裔美国人比他们的白色同龄人经历更多的压力。的 对非洲裔美国妇女来说，情况更加可怕，她们同时面临种族歧视和 性别歧视事实上，在所有社会经济领域，对黑人妇女来说，性别种族歧视几乎无处不在。 程度.这也是一种独特的压力形式，与其他非种族或性别相关的压力相比， 压力源最后，压力对健康有明显的下游负面影响。 据我们所知，没有移动的认知行为压力管理干预（m-CBSMi）， 该市场旨在帮助非裔美国妇女管理种族和非种族的日常压力。我们 想要填补这个空白。使用经过验证的CBSMi技术，黑人女性将学习如何管理自己的压力 通过短信和集成的移动的网络内容。支持性的文本将激励、激励和肯定 非裔美国女性的生活经历教育文本将增加知识，发展技能， 减少适应性应对的障碍。一个个性化定制的视频库将根据 她的个人经历。所有移动的Web内容将只能通过基于触摸的链接访问 嵌入在文本消息中，使其容易和毫不费力地查看这些材料。 在第一阶段，开发了m-CBSMi原型。这一发展是由形成性研究提供信息的 与社区护理提供者以及24名非洲裔美国妇女一起进行。的结果 第一阶段大力支持干预的可行性和潜在有效性，远远超过 第一阶段提案中确定的基准。 在第二阶段，我们将完成为非裔美国妇女开发m-CBSMi。然后在 与家庭和医疗咨询服务合作，我们将检查m-CBSMi的有效性， 减轻非裔美国妇女的压力。参与者将被随机分配到 干预条件或匹配的控制条件。次要措施将评估应对，福祉， 主观健康、性别种族认同和知识。

PROJECT SUMMARY/ABSTRACT The unjust social, economic, and environmental conditions that African Americans face throughout their lives lead to pervasive health disparities. These disparities are driven by healthcare differences, where White patients are more likely to receive medical procedures when they seek care, and it is of higher quality, than what is received by African Americans. They are driven by economic differences, where the net worth of non- Hispanic White households is $132,000 while it is only $9,000 for Black households. Those with less financial wealth have poorer health as compared to those with higher socioeconomic status. And yet, even when controlling for these two important social determinants of health, race still predicts morbidity and mortality. What can account for this? Stress. African Americans experience more stress than their White peers. The story is even more dire for African American women who simultaneously face both racial discrimination and sexism. Indeed, gendered racial discrimination is nearly ubiquitous for Black women at all socioeconomic levels. It is also a distinct form of stress, with unique outcomes compared to other non-race-or-gender-related stressors. Finally, stress has clear downstream negative effects on health. To our knowledge, there is no mobile cognitive–behavioral stress management intervention (m-CBSMi) on the market that is designed to help African American women manage racial and nonracial daily stress. We intend to fill this void. Using proven CBSMi techniques, Black women will learn how to manage their stress through text messages and integrated mobile web content. Supportive texts will inspire, motivate, and affirm the life experiences of African American women. Educational texts will increase knowledge, develop skills, and reduce barriers to adaptive coping. A library of individually tailored videos will be delivered to each user based on her personal experiences. All mobile web content will be accessible only through touch-based links embedded within text messages, making it easy and effortless to view this material. In Phase I, a prototype m-CBSMi was developed. This development was informed by formative research with community-based care providers plus 24 African American women across the lifespan. The results of Phase I strongly support the feasibility and potential effectiveness of the intervention, far exceeding the benchmarks established in the Phase I proposal. During Phase II we will complete development of the m-CBSMi for African American women. Then, in partnership with Family and Medical Counseling Service, we will examine the effectiveness of the m-CBSMi to reduce stress among African American women. Participants will be randomly assigned to either the intervention condition or to a matched control condition. Secondary measures will assess coping, well-being, subjective health, gendered racial identity, and knowledge.