title: An Intervention to Reduce Psychosocial and Biological Indicators of Stress in African American Lupus Patients: The Balancing Lupus Experiences with Stress Strategies Study.
abstract: OBJECTIVE
  Very little is known about the impact of psychosocial stress on African American lupus patients. Due to the exposure of African Americans to a unique trajectory of stressors throughout life, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group.
  
  
  METHODS
  The Balancing Lupus Experiences with Stress Strategies (BLESS) study piloted the validated "Better Choices, Better Health" Chronic Disease Self-Management Program (CDSMP) in 30 African-American lupus patients participating in the SLE Clinic Database Project at the Medical University of South Carolina (MUSC). Measures of psychosocial and biological indicators of stress were collected in all of the patients in each of the study conditions before and after intervention activities, as well as four months post-intervention, to assess the effectiveness of the program in reducing perceived and biological indicators of stress.
  
  
  RESULTS
  Participation in the workshops had large effects upon depression (d=1.63 andd= 1.68), social/role activities limitations (d=1.15), health distress (d=1.13 andd= 0.78), fatigue (d=1.03), pain (d=0.96), and lupus self-efficacy (d=0.85). Neither the differences in cortisol or DHEA levels pre- and post-intervention were found to be significantly different between intervention participants and controls.
  
  
  CONCLUSIONS
  The intervention workshops acted to reduce perceived stress and improve quality of life. Our findings imply that comparable, if not more significant gains in relevant health indicators are possible in African American patients when provided the opportunity to participate in CDSMP's.
authors.affiliation: Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 208, Columbia, SC 29210.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Williams
authors.affiliation: Institutional Assessment and Compliance, University of South Carolina, 1710 College Street, Suite 205, Columbia, SC 29208.
authors.forename: Megan
authors.initials: M
authors.lastname: Penfield
authors.affiliation: Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 816, Charleston, SC 29425.
authors.forename: Diane
authors.initials: D
authors.lastname: Kamen
authors.affiliation: Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 816, Charleston, SC 29425; Medical Service, Ralph H. Johnson VA Medical Center, Charleston, SC.
authors.forename: James C
authors.initials: JC
authors.lastname: Oates