title: Results from the Trial Using Motivational Interviewing, Positive Affect, and Self-Affirmation in African Americans with Hypertension (TRIUMPH).
abstract: Our objective was to determine the effectiveness of combining positive affect and self-affirmation strategies with motivational interviewing in achieving blood pressure control among hypertensive African Americans (AA) compared with AA hypertensives in an education-only control group.
  
  
  
  Randomized trial.
  
  
  
  Ambulatory practices in the South Bronx and Harlem, New York City.
  
  
  
  African American adults with uncontrolled hypertension.
  
  
  
  Participants were randomized to a positive affect and self-affirmation intervention or an education control group. The positive affect and self-affirmation intervention involved having participants think about things that made them happy and that reminded them of their core values on a daily basis. These strategies were reinforced every two months through motivational interviewing. The control arm received a workbook of strategies on blood pressure control. All participants were called every two months for one year.
  
  
  
  Blood pressure control rate.
  
  
  
  A total of 238 participants were randomized. The average age was 56 ± 11 years, approximately 70% were female, 80% were not married, and up to 70% had completed high school. There was no difference in control rates between the intervention and the control group. However, at one year, female participants were more likely to be controlled. Participants with high depressive symptoms or high perceived stress at baseline were less likely to be controlled.
  
  
  
  While this study did not demonstrate an intervention effect, it does provide important insight into the psychosocial factors that may underlie blood pressure control in African Americans. Implications for future behavioral intervention trials are discussed.
authors: Weill Cornell Medical College, Department of Medicine.
authors: Carla
authors: C
authors: Boutin-Foster
authors: Weill Cornell Medical College, Department of Medicine.
authors: Emanuela
authors: E
authors: Offidani
authors: Lincoln Medical Center, Department of Administration.
authors: Balavenkatesh
authors: B
authors: Kanna
authors: Lincoln Medical Center, Department of Administration.
authors: Gbenga
authors: G
authors: Ogedegbe
authors: New York University School of Medicine, Department of Population Health.
authors: Joseph
authors: J
authors: Ravenell
authors: New York University Langone Medical Center.
authors: Ebony
authors: E
authors: Scott
authors: Weill Cornell Medical College, Department of Medicine.
authors: Anna
authors: A
authors: Rodriguez
authors: Weill Cornell Medical College, Department of Medicine.
authors: Rosio
authors: R
authors: Ramos
authors: Lincoln Medical Center, Department of Administration.
authors: Walid
authors: W
authors: Michelen
authors: Weill Cornell Medical College, Department of Healthcare Policy and Research.
authors: Linda M
authors: LM
authors: Gerber
authors: Weill Cornell Medical College, Department of Medicine.
authors: Mary
authors: M
authors: Charlson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001794:Blood Pressure; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D009519:New York City; D012107:Research Design
keywords: African Americans; Blood Pressure; Medication Adherence; Motivational Interviewing; Positive Affect; Self-Affirmation