Culturally appropriate storytelling may help control blood pressure in African Americans
If you've ever sought information about how to cope with a medical condition, chances are that other patients were one of your best sources. Listening to the stories of people "in the same boat" can bolster us in many ways; for example, it can help us stick with sometimes burdensome treatments. Personal storytelling has long had a place in medicine — in support groups and doctor-patient relationships, for example. But how it affects the behavior of patients is hard to test. Now, in a trial, researchers have found that the blood pressure of patients with uncontrolled hypertension improved after they viewed DVDs of other people in their community talking about their own experiences with hypertension. Results were published in Annals of Internal Medicine (Jan. 18, 2011).
The study. Researchers at the University of Massachusetts Medical Center in Worcester, Mass., working with colleagues in Birmingham, Ala., randomly assigned 299 inner-city African Americans with hypertension (more than two-thirds of them women) to either usual care or a "storytelling" intervention in which they watched interviews with other inner-city African Americans who talked about living with high blood pressure. Some of them had their hypertension under control and others did not. All of the study subjects were given three DVDs. The intervention group received the storytelling DVDs, while the usual care group received DVDs covering health topics but nothing specifically about hypertension. Both groups watched the first set of DVDs in the clinic and were mailed the next two sets at home three months later and six months later. Blood pressure was measured at the start of the study, three months later, and then six to nine months later. Researchers also asked participants how much time they spent viewing the DVDs.
Results. In both groups, volunteers whose blood pressure was under control at the start of the study showed little change. But among participants with uncontrolled hypertension, there was a substantial difference. Patients who viewed the storytelling DVDs showed an average decline of 17 points in systolic pressure (the higher number) and 7 points in diastolic pressure after three months, compared with 6 points and 1 point, respectively, among participants receiving usual care. After three months, blood pressure rose somewhat in both groups, but the storytelling group still showed a greater net reduction in both systolic and diastolic pressure after six to nine months. Blood pressure changes were not related to reported time spent viewing the DVDs.