Self-Management Interventions for Black Women at Risk for Cardiovascular Disease: A Systematic Literature Review.

Abstract

Cardiovascular disease (CVD) is the leading cause of death among Black women. When compared with their non-Hispanic White counterparts, Black women are about 50% more likely to have uncontrolled high blood pressure (BP). The disproportionate burden of CVD in Black women highlights the need for CVD prevention programs in this population. The present systematic literature review examined the updated literature on the efficacy of primary prevention self-management interventions for Black women with CVD risk factors. Searches were run on PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases based on the following inclusion criteria: papers published from September 22, 2018; English language; U.S. studies only; original research reports; prospective clinical trials; cardiovascular health promotion/self-management interventions that target at least two health practices for primary prevention; comorbid conditions without a cardiovascular event; at least one patient-level outcome; and Black women at least 18 years of age. Twelve papers met the inclusion criteria. Health practices targeted included physical activity, nutrition, weight loss, health knowledge, and BP control. Nine of the 12 papers reported statistically significant improvements on at least one CVD risk factor including weight loss, physical activity, BP control, waist circumference, and depression. Culturally tailored self-management interventions appear to be feasible with weak to moderately high evidence of efficacy for reducing CVD risk factors in Black women. Further research should focus on the influence that social determinants of health, including mental health, may have on self-management and CVD risk in this population.