With the unprecedented growth of technology for disease prevention and management, little is known about the experience and adoption of such technology in African American older adults with hypertension. A 90-minute focus group session was used to explore African American older adults' ( N = 21) experiences with using technology (mobile devices and applications) for hypertension self-management. Twenty participants reported owning smartphones and used this technology to communicate; seek, acquire, and share information; engage in entertainment; and organize and manage time. Participants expressed concerns about not being informed or trained sufficiently to integrate technology for hypertension self-management. There is a need to develop novel hypertension self-management interventions that integrate technology and training programs for this marginalized population that may help improve blood pressure control and address important clinical and public health priorities of uncontrolled hypertension. [Res Gerontol Nurs. 2018; 11(5):249–256.]

African Americans are disproportionately impacted by hypertension, suffering earlier onset and greater severity of the disease, and premature cardiovascular mortality, than the general population. Managing hypertension is an unending concern for African American older adults. A better understanding of the self-management preferences of this vulnerable population will lead to the enhanced design of culturally acceptable interventions. This descriptive study examined focus group participants’ perspectives on engaging in hypertension self-management activities with the goal of developing a co-created intervention. This study was part of a mixed methods study for which audio- and graphically-recorded focus groups were conducted with community-dwelling African American older adults (N = 31) diagnosed with hypertension. The majority of the participants were women (87%); the mean age was 72 years (SD = 7.53). Themes derived from data analyses centered on primary stressors of communication, healthy eating, and sleep related to blood pressure self-management. Based on these, the researchers co-created educational interventions.

Background: Racial discrimination is one of many barriers experienced by African Americans that interfere with health self-care management. Discrimination stress may decrease the tendency for individuals to resonate with the social–emotional appeals embedded in persuasive health information, which are known to play a key role in producing behavior change. Understanding the neurobehavioral underpinnings of discrimination stress experienced by African Americans may help reduce or resolve this important health disparity. Objectives: The purpose of this secondary analysis was to examine the association between neural processing of health information and perceived discrimination. In particular, we focused on three previously identified measures of health information processing associated with distinct brain areas: analytic network, empathy network, and the ventral medial prefrontal cortex. Methods: Data were obtained from 24 African Americans enrolled in a blood pressure self-care management study. Participants completed surveys assessing racial discrimination and global stress, as well as a 40-minute functional magnetic resonance imaging protocol used to measure neural activation associated with processing different types of health information. Results: Discrimination stress was significantly related to reduced activation of the empathy network and ventral medial prefrontal cortex, whereas there was a nonsignificant positive relationship with activity in the analytic network. Discussion: Uncovering associations between patient experiences, such as racial discrimination, and their neural processing of health information can lead to the development of tailored health messages and self-care management interventions. This may inform strategies to close the gap on health outcomes.

Introduction/Purpose: Cardiovascular disease (CVD) is the leading cause of death worldwide, and in the United States alone, CVD causes nearly 840,000 deaths annually. Using functional magnetic resonance imaging (fMRI), a tool to assess brain activity, researchers have identified some brain-behavior connections and predicted several self-management behaviors. The purpose of this study was to examine the sample characteristics of individuals with CVD who participated in fMRI studies. Methods: A literature search was conducted in PubMed, CINAHL, and Scopus. No date or language restrictions were applied and research methodology filters were used. In October 2017, 1659 titles and abstracts were identified. Inclusion criteria were: (1) utilized an empirical study design, (2) used fMRI to assess brain activity, and (3) focused on patients with CVD-related chronic illness. Articles were excluded if they: were theory or opinion articles, focused on mental or neuropathic illness, included non-human samples, or were not written in English. After duplicates were removed (230), 1,429 titles and abstracts were reviewed based on inclusion criteria; 1,243 abstracts were then excluded. A total of 186 studies were reviewed in their entirety; after additional review, 142 were further excluded for not meeting the inclusion criteria. Forty-four articles met criteria and were included in the final review. An evidence table was created to capture the demographics of each study sample. Results: Ninety eight percent of the studies did not report the racial or ethnic composition of their sample. Most studies (66%) contained more men than women. Mean age ranged from 38 to 78 years; 77% reported mean age ≥50 years. The most frequently studied CVD was stroke (86%), while hypertension was studied the least (2%). Conclusion: Understanding brain-behavior relationships can help researchers and practitioners tailor interventions to meet specific patient needs. These findings suggest that additional studies are needed that focus on populations historically underrepresented in fMRI research. Researchers should thoughtfully consider diversity and purposefully sample groups by including individuals that are: women, from diverse backgrounds, younger, and diagnosed with a variety of CVD-related illnesses. Identifying and addressing these gaps by studying more representative samples will help healthcare providers reduce disparities and tailor interventions for all CVD populations.