Abstract TH808: Culturally Tailored Positive Psychological Intervention in a Cluster-Randomized Trial of Blood Pressure Reduction in Spanish-Speaking Hispanics/Latinos with Uncontrolled Hypertension

Abstract

Introduction: Positive psychological interventions (PPIs) have demonstrated benefits for mental health and health behaviors, but their effects on physiologic cardiovascular outcomes remain underexamined. We tested whether ¡Alégrate! , a culturally adapted, church-based PPI, lowers blood pressure (BP) and promotes medication adherence in Spanish-speaking Hispanic/Latino adults with uncontrolled hypertension. Hypothesis: We hypothesized that ¡Alégrate! participants would show greater BP reductions and better adherence than controls, with stronger effects among those attending more sessions. Methods: In a cluster-randomized controlled design (six urban-area churches), 96 adults (51 intervention, 45 control) with uncontrolled hypertension (2017–2019) were enrolled. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale, and seated blood pressure (mm Hg) was measured objectively following a standardized protocol. The 8-week, group-based curriculum was delivered in Spanish and embedded cultural values (familism, religiosity). Core modules included mindfulness, gratitude, positive reappraisal, and goal setting to promote psychological well-being. Assessments occurred at baseline, 8 weeks, and 12 weeks. We used linear mixed models with random intercepts to estimate fixed effects of group, time, and their interaction, and conducted exploratory dose–response analyses by attendance. Results: Group × time interactions for systolic and diastolic BP did not reach statistical significance ( p = 0.09 and 0.07), though both trended toward improvement in the intervention arm. At 8 weeks, mean systolic BP decreased by –5.8 mm Hg ( p = 0.045) and diastolic BP by –4.0 mm Hg ( p = 0.065) versus control; effects attenuated by 12 weeks. In exploratory analyses, participants attending ≥ 6 sessions maintained more stable BP trajectories. No between-group differences were observed in medication adherence. Conclusions: In this pilot community-based trial, a culturally tailored PPI produced short-term systolic BP reductions in Spanish-speaking Hispanic/Latino adults with uncontrolled hypertension. These findings support the potential of positive psychological approaches to reduce hypertension disparities. Larger, longer trials are needed to confirm and extend these effects.