Culturally appropriate storytelling to improve blood pressure: a randomized trial.
BACKGROUND
Storytelling is emerging as a powerful tool for health promotion in vulnerable populations. However, these interventions remain largely untested in rigorous studies.


OBJECTIVE
To test an interactive storytelling intervention involving DVDs.


METHODS
Randomized, controlled trial in which comparison patients received an attention control DVD. Separate random assignments were performed for patients with controlled or uncontrolled hypertension. (ClinicalTrials.gov registration number: NCT00875225)


METHODS
An inner-city safety-net clinic in the southern United States.


METHODS
230 African Americans with hypertension.


METHODS
3 DVDs that contained patient stories. Storytellers were drawn from the patient population.


METHODS
The outcomes were differential change in blood pressure for patients in the intervention versus the comparison group at baseline, 3 months, and 6 to 9 months.


RESULTS
299 African American patients were randomly assigned between December 2007 and May 2008 and 76.9% were retained throughout the study. Most patients (71.4%) were women, and the mean age was 53.7 years. Baseline mean systolic and diastolic pressures were similar in both groups. Among patients with baseline uncontrolled hypertension, reduction favored the intervention group at 3 months for both systolic (11.21 mm Hg [95% CI, 2.51 to 19.9 mm Hg]; P = 0.012) and diastolic (6.43 mm Hg [CI, 1.49 to 11.45 mm Hg]; P = 0.012) blood pressures. Patients with baseline controlled hypertension did not significantly differ over time between study groups. Blood pressure subsequently increased for both groups, but between-group differences remained relatively constant.


CONCLUSIONS
This was a single-site study with 23% loss to follow-up and only 6 months of follow-up.


CONCLUSIONS
The storytelling intervention produced substantial and significant improvements in blood pressure for patients with baseline uncontrolled hypertension.


BACKGROUND
Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation.
Bedford Veterans Affairs Medical Center, Massachusetts, USA. Thomas.Houston@umassmed.edu
Thomas K
TK
Houston
Jeroan J
JJ
Allison
Marc
M
Sussman
Wendy
W
Horn
Cheryl L
CL
Holt
John
J
Trobaugh
Maribel
M
Salas
Maria
M
Pisu
Yendelela L
YL
Cuffee
Damien
D
Larkin
Sharina D
SD
Person
Bruce
B
Barton
Catarina I
CI
Kiefe
Sandral
S
Hullett
D001741:Black or African American / Q000193:education*; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D001794:Blood Pressure; D003469:Culture; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011203:Poverty; D016896:Treatment Outcome; D014505:Urban Population; D014742:Videodisc Recording