Stress Management for Hypertension (LifeSkills Workshop)

While behavioral interventions can improve blood pressure (BP) in individuals with hypertension, getting such services to people who could benefit remains difficult. Workplace programs have potential as dissemination vehicles. The objective is to evaluate the effectiveness of a standardized stress management program delivered in groups at the workplace for reducing BP compared with enhanced usual care. This randomized controlled trial studied 92 urban medical center employees with hypertension randomized into two groups. The intervention was a 10-week group workshop on cognitive-behavioral coping skills. Enhanced usual care included self-help materials for BP reduction and physician referral. Intervention group participants’ systolic BP (SBP) decreased 7.5 mm Hg over controls between baseline and follow-up, from 149.1 (95% CI: 146.0–152.1) to 140.0 (95% CI: 134.7–145.2), p < .001. The differential change between intervention and enhanced usual care groups (Group × Time interaction) was 7.5 mm Hg (t = −2.05; p = .04). Diastolic BP reductions were not significantly different. Scores on measures of emotional exhaustion and depressive rumination showed significant improvements and correlated with reductions in SBP. There was no significant change in the usual care group. A standardized worksite group intervention produced clinically meaningful reductions in SBP in participants with hypertension.

Implications
Practice: A standardized 10-session stress and anger management program delivered in groups in the workplace proved to be a practical and successful approach to reducing SBP in hypertensive employees.

Research: The possibility of decreases in BP being mediated by changes in emotional exhaustion or depressive rumination should be explored in future research and can be effective in reducing BP in hypertensive employees.

Policy: The workplace may be an excellent venue for dissemination of group psychosocial interventions to address chronic conditions or health behaviors, given the high rate of retention of participants in completing the intervention.

Rank: 2

First Author: Clemow

Outcome: Emot. Exhaust./Comp. Fatig.,Depression

Outcome p-value: Emotional Exhaustion/Compassion Fatigue:⭑, Depression:⭑

Intervention Category: Coping Skills Development

Time per Employee (hours): 10

Hours per Employee: 10

D&B Study Quality Rating: 22

Reviewer Confidence: 3.5

Country: US

Study Design Type: RCT

Materials Available to Implement: The LifeSkills Workshop manual and training video are available; group facillitations trained per guidelines from Williams LifeSkills, Inc. Corresponding author: clemowlp@rwjms. rutgers.edu

Materials Available: yes

Organiz./Individ. Focus: Individual

Prevention Category: Secondary

Effect Size: Small

Effect size Small: Emot. Exhaust./Comp. Fatig.,Depression

Effect size Medium:

Reference: Clemow, Lynn P, Thomas G Pickering, Karina W Davidson, Joseph E Schwartz, Virginia P Williams, Jonathan A Shaffer, Redford B Williams, and William Gerin. “Stress Management in the Workplace for Employees with Hypertension: A Randomized Controlled Trial.” Translational Behavioral Medicine 8, no. 5 (September 8, 2018): 761–70. https://doi.org/10.1093/tbm/iby018.