Culturally Appropriate Storytelling to Improve Blood Pressure

African-Americans with uncontrolled high blood pressure benefited from an intervention using DVDs of real patients' stories of how they dealt with their chronic disease.

Racial disparities persist for cardiovascular diseases including hypertension, which is more prevalent among Blacks than Whites. Hypertension control is particularly complex, requiring long-term adherence to medication, diet, exercise and medical follow-up. Differences in blood pressure control are partially explained by an unhealthy diet, environmental factors, limited access to care and poor medication adherence.

The researchers of this study sought to develop and test a novel, evidence-based and culturally appropriate intervention to control blood pressure in African-Americans using storytelling DVDs. They randomly assigned to two groups 299 Black patients with high blood pressure from an inner-city safety-net hospital in Birmingham, Alabama; 230 patients were retained throughout the study. The control group watched a DVD on attention control, while others watched a DVD that showed real patients telling about their experiences of living with high blood pressure and suggesting strategies to increase medication adherence. The baseline systolic blood pressure of both groups was 133 mm Hg. Patients in the intervention group received two more DVDs with different patient stories mailed to their homes at three and six months. Those patients spent an average 87.5 minutes watching the DVDs.

Patients who had controlled hypertension at baseline experienced no significant change in blood pressure over time. Patients with uncontrolled hypertension, however, benefited from the intervention and experienced blood pressure reductions of 11 mm Hg systolic and 6 mm Hg diastolic at three months.