TITLE:
An intervention to reduce psychosocial and biological indicators of stress in African American lupus patients: The balancing lupus experiences with stress strategies study
AUTHORS:
Edith M. Williams, Megan Penfield, Diane Kamen, James C. Oates
KEYWORDS:
Lupus; Stress; African-American; Self-Management
JOURNAL NAME:
Open Journal of Preventive Medicine,
Vol.4 No.1,
January
17,
2014
ABSTRACT:
Objective: Very
little is known about the impact of psychosocial stress on African American lupus patients. Due to the exposure of African Americans to a unique trajectory
of stressors throughout life, it may be critical to understand the relationship
between psychosocial stress and underlying biological mechanisms that influence
disease activity and pathology in this high risk group. Methods: The Balancing
Lupus Experiences with Stress Strategies (BLESS) study piloted
the validated “Better Choices, Better Health” Chronic Disease
Self-Management Program (CDSMP) in 30 African-American lupus patients
participating in the SLE Clinic Database Project at the Medical
University of South Carolina (MUSC). Measures of psychosocial and biological
indicators of stress were collected in all of the patients in each of the study
conditions before and after intervention activities, as well as four months’
post-intervention, to assess the effectiveness of the program in reducing perceived
and biological indicators of stress. Results: Participation in the
workshops had large effects upon depression (d = 1.63 and d = 1.68),
social/role activities limitations (d =1.15), health distress (d = 1.13 and d = 0.78), fatigue (d = 1.03), pain (d = 0.96), and lupus self-efficacy (d = 0.85). Neither the differences in cortisol or DHEA levels
pre- and post-intervention were found to be significantly different between
intervention participants and controls. Conclusion: The intervention
workshops acted to reduce perceived stress and improve quality of life. Our
findings imply that comparable, if not more significant gains in relevant
health indicators are possible in African American patients when provided the
opportunity to participate in CDSMP’s.