Outcomes of a Prospective Pilot RCT of a Remotely Delivered Self-Management Program (TEAM-Red) for Depressed Young Black Women at Risk for Hypertension.

Abstract

ObjectiveFew studies have simultaneously addressed self-management of cardiovascular and mental health in Black women at cardiovascular risk. This 24-week pilot prospective crossover randomized-controlled trial tested TEAM-Red, a 5-session, biweekly, nurse and peer-educator remotely delivered group self-management intervention for young Black women, vs Enhanced waitlist control (eWL).MethodsTEAM-Red intervention, adapted from an evidence-based program and culturally tailored based on stakeholder input, enrolled 50 depressed Black women ages 18-49 with at least one risk factor for hypertension. Participants were randomized to TEAM-Red (n = 25) or eWL (n = 24) and assessed at Screening, Baseline, 12 weeks, and 24 weeks. Those in eWL crossed over to receive TEAM-Red at 12 weeks and all participants were followed to 24 weeks. The primary goal was acceptability and feasibility. The primary outcome was change on depression severity from baseline to 12 weeks assessed via 9-item Patient Health Questionnaire (PHQ-9). Secondary outcomes were perceived stress, mental health quality of life, diet quality, energy expended, social support, hypertension knowledge, and alcohol use.ResultsAmong women depressed at baseline (N = 31), TEAM-Red participants had 17.1 times higher odds of depression remission at week 12 (OR = 17.14, 95% CI: 1.78, 164.97; P = .014). At 12 weeks, TEAM-Red participants showed significantly lower PHQ-9 scores (P = .042), improved diet quality (P = .025) and mental health quality of life (P = .032) and reduced perceived stress (P = .038) compared to eWL. Treatment satisfaction and engagement was high (89% found it useful), with 22% attrition.ConclusionsTEAM-Red demonstrated significant clinical benefits with a 17-fold higher odds of depression remission and meaningful improvements in mental health quality of life, diet quality, and perceived stress compared to controls. Despite limitations including small sample size and short follow-up period, this culturally tailored intervention shows promise for reducing cardiovascular risk and improving mental health outcomes in young Black women at risk for hypertension should results be replicated with a larger sample in a fully powered trial.