Learning Objective #1: Identify how stress is viewed as a health disparity indicator in high blood pressure research

Learning Objective #2: Compare how stress was conceived by research pariticipants in two different regional contexts as influencing high blood pressure management

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Background: Studies exploring stress and high blood pressure disparity among African Americans are on the rise. These approaches, though promising, often do not compare the different life experiences of African Americans across geographic locales. Purpose: This presentation explores how African Americans in South Louisiana and Central Washington discussed stress and high blood pressure. Sample: A convenience sample (N=30) of African-American women (n=15) and men (n=15) with high blood pressure were study participants in South Louisiana. A purposive sample (N=37) of African-American women (n=15) and men (n=22 ) were study participants in Central Washington. Methods: Most participants were interviewed twice, using the same open-ended interview guide. Studies were conducted one year apart from 1999-2000 and 2001-2002 respectively. Discourse analysis, field experiences, and the assistance of community consultants were critical to data analysis in both locations. Results: African Americans in rural Louisiana distinguished between worry and stress. Worry was associated with concerns about self, children, kin and community health. Stress involved having multiple obligations and encountering multiple forms of discrimination. African Americans in urban Washington voiced that workplace and neighborhood stress impacted their high blood pressure management more often than worry or private concerns. Like participants in Louisiana, they too distinguished between stress and worry/concerns. Washington participants, however, noted that stress was more of a hinderance to the effective control of their blood pressure. Stress was most often discussed in terms of discriminatory encounters in the workplace and public. Implications: Worry and stress are important variables to study in relation to high blood pressure. Inattention to how African Americans contextually perceive worry and stress as affecting their high blood pressure can result in misdirected health care communications and interventions.

National Institute of Nursing Research (F31 NR07249-01); and Centers for Disease Control and Prevention (U48/CCU009654-06). Appreciation is extended to Joseph Fletcher III.