Stress Reduction Intervention for Racism-Related Stress

Overseen By Cara Joyce, PhD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Loyola University

Must not be taking: Glucocorticoids

Disqualifiers: Heart disease, Immune diseases, Cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 11

Duration: 8 weeks

300 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests if the RiSE program, a short online stress reduction course, can improve well-being and health in African American women at risk for heart or other health issues. The program teaches techniques to manage social stress and promote empowerment. The RiSE program is a short group-based stress reduction program designed to help Black women at risk for heart disease develop effective coping skills for dealing with chronic stress uniquely associated with being a minority.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. However, if you are using immune-altering medications like glucocorticoids, you may not be eligible to participate.

What data supports the effectiveness of the treatment HEP, Health Education Program, RiSE, Resilience, Stress, and Ethnicity program for reducing racism-related stress?

Research suggests that interventions aimed at reducing racism can improve health by addressing social factors and empowering individuals, which aligns with the goals of the RiSE program. Additionally, coping strategies like John Henryism have shown positive health effects in managing stress related to racism, indicating potential benefits of similar stress reduction interventions. ^{1 2 3 4 5}

How is the HEP, RiSE treatment different from other treatments for racism-related stress?

The HEP, RiSE treatment is unique because it is a culturally tailored, group-based program specifically designed to help Black women at risk for cardiovascular disease develop coping skills for chronic stress related to racism, which is not addressed by standard treatments. It focuses on resilience and stress management, making it distinct from other interventions that may not consider the specific stressors faced by minorities. ^{6 7 8 9 10}

Research Team

Karen Saban, RN, PhD

Principal Investigator

Loyola University Chicago

Eligibility Criteria

This trial is for African American women aged 50-70, post-menopausal, who can read and speak English. They must have risk factors for heart or metabolic disease like high blood pressure, large waist circumference, high cholesterol, or Type 2 diabetes. Excluded are those on immune-altering meds, with recent dental issues, smokers within 3 months, active cancer/infection/substance abuse issues or significant cardiovascular history.

Inclusion Criteria

Able to write, read, speak English

Self-identified AA or Black

I have a waist size over 88 cm, high blood pressure, high cholesterol, or Type 2 diabetes.

Exclusion Criteria

I have a history of heart issues or stroke.

Substance abuse

Current smoker or has smoked in past 3 months

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in either the RiSE or Health Education program, meeting online weekly for 8 consecutive weeks

8 weeks

8 visits (virtual)

Booster Sessions

Two booster sessions occur one month and two months after completion of the interventions

2 months

2 visits (virtual)

Follow-up

Participants are monitored for well-being, inflammation, and DNA methylation 6 months after the intervention

6 months

1 visit (in-person)

Treatment Details

Interventions

• HEP
• RiSE

Trial Overview The study compares two programs: RiSE (Resilience and Stress Education) focusing on stress reduction related to racial experiences versus a general Health Education program (HEP). Both groups meet online weekly for eight weeks. The impact on well-being and biological markers of stress will be measured through saliva tests and health check-ups before the intervention starts until six months after it ends.

Participant Groups

Group I: Resilience, Stress, and Ethnicity (RiSE) program Experimental Treatment 1 Intervention

Resilience, Stress, and Ethnicity (RiSE) program is an 8-session weekly group-based intervention that integrates cognitive-behavioral strategies focused on the biopsychosocial impact of racism, racial identity development, and empowerment. RiSE has three primary components: 1. processing and sharing experiences related to race based stress, 2. psychoeducation on the biopsychosocial impact of racism, 3. skill building and empowerment.

Group II: Health Education Program (HEP) Active Control 1 Intervention

Health Education Program

Who Is Running the Clinical Trial?

Loyola University

Lead Sponsor

Trials

161

Recruited

31,400+

Columbia University

Collaborator

Trials

1,529

Recruited

2,832,000+

Findings from Research

A student-led conference with 220 participants, including medical, nursing, and social work students, effectively increased comfort levels in discussing racism's impact on health, with 47.7% reporting improved comfort post-conference.

The conference also enhanced understanding of racism's effects on health for 36.4% of respondents and fostered connections among health professionals, indicating its potential as a valuable educational intervention in health care training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recognizing Racism in Medicine: A Student-Organized and Community-Engaged Health Professional Conference. Adelekun, AA., Beltrán, S., Carney, J., et al.[2022]

Interventions aimed at reducing institutional racism, such as improving neighborhood quality and access to resources, have been shown to enhance health outcomes and reduce health disparities.

Addressing cultural racism at both societal and individual levels, along with empowering communities, can further mitigate the negative health impacts of racism, highlighting the need for comprehensive policies in healthcare and social support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Racism and Health II: A Needed Research Agenda for Effective Interventions. Williams, DR., Mohammed, SA.[2023]

In a study of 352 predominantly African American participants, the coping strategy known as John Henryism was linked to lower systolic blood pressure in men, suggesting it may have a protective effect against stress-related health issues.

Conversely, experiences of racism and discrimination were associated with higher systolic blood pressure in men, highlighting the negative impact of discrimination on physical health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services. Barajas, CB., Jones, SCT., Milam, AJ., et al.[2022]

The study developed two brief writing interventions focused on justice and injustice, showing that these prompts can significantly influence how African Americans respond to acute social stress, particularly during a stress test.

Results indicated that men benefited from the personal justice-only condition with improved emotional responses and lower blood pressure reactivity, while women showed more negative emotional responses and poorer performance, highlighting the need to consider gender differences in stress coping strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Writing about justice and injustice: Complex effects on affect, performance, threat, and biological responses to acute social stress among african American women and men. Lucas, T., Yamin, JB., Krohner, S., et al.[2023]

In a study of 144 African American adults in New York City, women reported fewer lifetime incidents of racism compared to men, but both genders experienced similar levels of everyday racism.

Higher education levels were linked to increased reports of racism, particularly among men, while subjective social status showed a negative association, indicating that perceptions of social standing may influence experiences of racism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Racism at the intersections: Gender and socioeconomic differences in the experience of racism among African Americans. Kwate, NO., Goodman, MS.[2022]

The 8-week group-based stress reduction program, Resilience, Stress and Ethnicity (RiSE), was found to be feasible and effective for Black women at risk for cardiovascular disease, with a low attrition rate of 13% and high participant satisfaction.

Participants reported significant improvements in coping with stress related to perceived discrimination and racism, with 81% practicing the skills learned in real-life situations, indicating the program's potential to address chronic stress and reduce health disparities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Qualitative evidence for Resilience, Stress, and Ethnicity (RiSE): A program to address race-based stress among Black women at risk for cardiovascular disease. Conway-Phillips, R., Dagadu, H., Motley, D., et al.[2022]

Black adolescents in low-income communities face higher risks of mental health issues due to poverty and discrimination, yet they have low rates of mental health service use, leading to unmet needs.

The Coping With Stress (CWS) Course has been adapted into the Resilient In spite of Stressful Events (RISE) program to better serve Black adolescents, incorporating cultural modifications to enhance its effectiveness in addressing their specific challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adaptation of the Coping With Stress Course for Black Adolescents in Low-Income Communities: Examples of Surface Structure and Deep Structure Cultural Adaptations. Clarke, AT., Soto, G., Cook, J., et al.[2023]

Two applied programs, Engaging, Managing, and Bonding through Race and Family Learning Villages, have been developed to help Black Americans heal from racial discrimination by focusing on families and schools as key support systems.

These programs utilize strengths-based and participatory approaches that leverage the protective mechanisms within Black communities, aiming to improve mental health and address the unique challenges faced in accessing quality mental health services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hands Up, Now What?: Black Families' Reactions to Racial Socialization Interventions. Anderson, RE., Metzger, I., Applewhite, K., et al.[2022]

A peer-led compassionate meditation program was developed and pilot-tested with Asian American college students, showing promising results in reducing general distress, depression, anxiety, and PTSD symptoms.

Participants experienced a decrease in clinical depression by the end of the 8-session program, suggesting that culturally responsive meditation may be an effective and cost-efficient intervention for addressing race-related stress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Compassionate meditation to heal from race-related stress: A pilot study with Asian Americans. Hwang, WC., Chan, CP.[2022]

The pilot randomized controlled trial will assess the feasibility and acceptability of the Race-Based Stress and Trauma Empowerment (RBSTE) intervention among 48 Veterans of Color experiencing perceived discrimination and stress, comparing it to an active control group receiving Present-Centered Therapy (PCT).

Outcomes will focus on psychological distress, discrimination, ethnoracial identity, holistic wellness, and allostatic load, aiming to provide insights into effective interventions for addressing the health impacts of racism in the Veteran population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mitigating the health effects of systemic racism: Evaluation of the Race-Based Stress and Trauma Empowerment intervention. Wang, C., Malaktaris, A., McLean, CL., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Recognizing Racism in Medicine: A Student-Organized and Community-Engaged Health Professional Conference. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Racism and Health II: A Needed Research Agenda for Effective Interventions. [2023]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Writing about justice and injustice: Complex effects on affect, performance, threat, and biological responses to acute social stress among african American women and men. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Racism at the intersections: Gender and socioeconomic differences in the experience of racism among African Americans. [2022]

6. Scotland pubmed.ncbi.nlm.nih.gov

Qualitative evidence for Resilience, Stress, and Ethnicity (RiSE): A program to address race-based stress among Black women at risk for cardiovascular disease. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Adaptation of the Coping With Stress Course for Black Adolescents in Low-Income Communities: Examples of Surface Structure and Deep Structure Cultural Adaptations. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Hands Up, Now What?: Black Families' Reactions to Racial Socialization Interventions. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Compassionate meditation to heal from race-related stress: A pilot study with Asian Americans. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Mitigating the health effects of systemic racism: Evaluation of the Race-Based Stress and Trauma Empowerment intervention. [2023]