Positive Psychology Intervention for Spanish-speaking Hispanic/Latino Adults at Risk for Cardiovascular Disease

Study Overview
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Brief Summary
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The largest epidemiologic study of Hispanic/Latino participants thus far, i.e., the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) documented that 80% of men and 71% of women have at least one major cardiovascular disease (CVD) risk factor. The American Heart Association emphasizes that current CVD prevention efforts are sparse and ineffectual in minority populations and acknowledges the need for new and more effective disease prevention strategies. This observational study and pilot cluster-randomized clinical trial seeks to implement and evaluate a novel 8-week Positive Psychology (PP) Intervention (compared to an attention control condition) in Hispanic/Latino adults with uncontrolled hypertension, i.e., elevated 24-hour ambulatory blood pressure, with primary interest in testing efficacy for clinically meaningful improvements in cardiovascular function.

Detailed Description
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The study features piloting of a cluster-randomized trial to determine whether a positive psychology (PP) intervention is associated with greater improvements in blood pressure compared to an attention control condition. The pilot trial additionally evaluates the efficacy of the PP intervention with respect to psychological well-being, hypertension-related health behaviors, autonomic cardiac control, and high-sensitivity C-reactive protein. Serum blood assays will facilitate exploration of mechanistic indicators linking psychological well-being to cardiac functioning.

Official Title
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Positive Psychology Intervention for Spanish-speaking Hispanic/Latino Adults at Risk for Cardiovascular Disease

Conditions
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Uncontrolled Hypertension, Cardiovascular Risk Factor

Intervention / Treatment
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* Behavioral: Positive Psychological Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hispanics/Latinos recruited from Catholic church sites in Chicago-land area aged ≥18 fluent in English or Spanish with ≥8th grade education elevated 24-hour ambulatory blood pressure levels (systolic BP> 140 mmHg and >90 mmHg for diastolic BP). Exclusion Criteria: Unavailable for study period; have cognitive impairment denoting dementia have severely reduced life expectancy are currently enrolled in psychotherapy or take prescribed antidepressants history or current diagnosis of bipolar disorder, dissociative disorder, psychosis, or substance abuse have severe depression.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Cluster-randomized control trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Positive Psychological Intervention<br>Our culturally-tailored Positive Psychology (PP) Intervention is a non-pharmacotherapy approach aimed at increasing positive emotional experiences by teaching individuals to engage in intentional activities known to increase psychological and emotional well-being through targeting of constructs such as optimism, gratitude, mindfulness/relaxation, and resilience. | Behavioral: Positive Psychological Intervention<br>* Our culturally-tailored Positive Psychology Intervention is a non-pharmacotherapy approach aimed at increasing positive emotional experiences by teaching individuals to engage in intentional activities known to increase psychological and emotional well-being through targeting of constructs such as optimism, gratitude, mindfulness/relaxation, and resilience.<br>* Other names: Positive Affect Intervention;|
| No Intervention: Wait list control<br>Receipt after the active treatment group has completed the positive psychological intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Ambulatory Blood Pressure at 8- and 12-weeks | The device, Vitavue, consists of a wireless microcontroller that connects to a desktop computer running proprietary software when operated in real time connected mode. Alternatively, it can be operated in standalone unconnected mode by logging acquired data to an internal memory storage device. The device contains a number of sensors including ECG single channel amplifier, Multispectral Photodiode to record photo pulse plethysmograms, temperature sensor to measure skin temperature, and an accelerometer to record the level of activity. | Baseline, 8-, and 12-weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Center for Epidemiological Studies Depression Scale (CESD): Change from Baseline Depressive Symptoms at 8- and 12-weeks | Center for Epidemiological Studies Depression-Scale | Baseline, 8-, and 12-weeks | 
| Life Orientation Test-Revised (LOT-R): Change from Baseline Dispositional Optimism at 8- and 12-weeks | Life Orientation Test-Revised | Baseline, 8-, and 12-weeks | 
| General Well-being Schedule: Change in Baseline Emotional Vitality at 8- and 12-weeks | General Well-being Schedule | Baseline, 8-, and 12-weeks | 
| Life Engagement Test (LET): Change in Baseline Life engagement and Meaning at 8- and 12-weeks | Life Engagement Test | Baseline, 8-, and 12-weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hispanics/Latinos, Underserved Population