Background—: Data are limited on the implementation of evidence-based multilevel interventions targeted at blood pressure (BP) control in hypertensive blacks who receive care in low-resource primary care practices. Methods and Results—: Counseling African Americans to Control Hypertension is a cluster-randomized clinical trial in which 30 community health centers were randomly assigned to the intervention condition (IC) or usual care (UC). Patients at the IC sites received patient education, home BP monitoring, and monthly lifestyle counseling, whereas physicians attended monthly hypertension case rounds and received feedback on their patients’ home BP readings and chart audits. Patients and physicians at the UC sites received printed patient education material and hypertension treatment guidelines, respectively. The primary outcome was BP control, and secondary outcomes were mean changes in systolic and diastolic BPs at 12 months, assessed with an automated BP device. A total of 1059 patients (mean age, 56 years; 28% men, 59% obese, and 36% with diabetes mellitus) were enrolled. The BP control rate was similar in both groups (IC=49.3% versus UC=44.5%; odds ratio, 1.21 [95% confidence interval, 0.90–1.63]; P =0.21). In prespecified subgroup analyses, the intervention was associated with greater BP control in patients without diabetes mellitus (IC=54.0% versus UC=44.7%; odds ratio, 1.45 [confidence interval, 1.02–2.06]); and small-sized community health centers (IC=51.1% versus UC=39.6%; odds ratio, 1.45 [confidence interval, 1.04–2.45]). Conclusions—: A practice-based, multicomponent intervention was no better than UC in improving BP control among hypertensive blacks. Future research on the implementation of behavioral modification strategies for hypertension control in low-resource settings should focus on the development of more efficient and tailored interventions in this high-risk population. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00233220.

The Scale of Ethnic Experience (SEE) is a new self-report instrument designed to measure multiple ethnicity-related cognitive constructs across ethnic groups. We present the development and psychometric properties here. We generated and refined an item pool using expert consultants and culturally diverse focus groups. We derived a final 32-item version of the SEE based on separate factor analyses of data from college students in 4 ethnic groups: African Americans, Caucasian Americans, Filipino Americans, and Mexican Americans. Four factors were consistent across the ethnic groups: Ethnic Identity, Perceived Discrimination, Mainstream Comfort, and Social Affiliation. We found evidence of test–retest reliability, internal consistency, and criterion and construct validity for all groups. Finally, we cross-validated the factor structure of the SEE in a culturally diverse sample. Results support the reliability and validity of the SEE as a multidimensional measure of ethnicity-related cognitive constructs that...

Although the Beck Depression Inventory and Beck Anxiety Inventory are two of the most widely used instruments for assessing depressive and anxious symptoms in both clinical and nonclinical populations, their cross-cultural reliability and validity have yet to be fully established. In this study, 2,703 Caucasian American and 1,110 Latino college students completed both measures. For each measure, exploratory factor analysis with promax rotation, conducted separately by ethnic group, revealed similar factor structures across groups. For both groups, and both instruments, factor analysis yielded highly similar two-factor solutions. Reliability, as evidenced by internal consistency coefficients, was good; all alphas exceeded .82. On both measures, Latino students scored significantly higher than Caucasian American students on total scores and women scored significantly higher than men. These results support the reliability, validity, and cultural equivalence of these measures of depressive and anxious symptomatology for use with Caucasian American and acculturated Latino younger college students.