Online Program

Stress intervention and disease in African American lupus patients: The balancing lupus experiences with stress strategies (BLESS) study

Wednesday, November 6, 2013 : 10:30 a.m. - 10:46 a.m.

Edith M. Williams, PhD, MS, Institute for Partnerships to Eliminate Health Disparities, University of South Carolina, Columbia, SC
Diane L. Kamen, MD, MSCR, Rheumatology & Immunology, Medical University of South Carolina, Charleston, SC
Megan Penfield, MS, Institutional Assessment and Compliance, University of South Carolina, Columbia, SC
BACKGROUND: Very little is known about the impact of psychosocial stress on underlying biological mechanisms in African American lupus patients, although African American women display the highest rates of lupus. Due to the exposure of African Americans to a unique trajectory of stressors throughout the life course, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. METHODS: To begin to fill this research void, an evidence based self-management program was piloted among a cohort of African American lupus patients participating in an SLE database project at the Medical University of South Carolina (MUSC). To assess disease activity, during each clinic visit, a history is obtained, and physical examination, phlebotomy, and urine collection are performed. SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) scores are assessed at each visit. Disease data corresponding with data collection timeframes for each participant were extracted from the MUSC SLE Database to assess the effectiveness of the program. RESULTS: Several differences were observed between the intervention and control groups on symptoms pertaining to lupus activity, and many of these differences had large effect sizes. DISCUSSION: Our findings can be rapidly translated into improved delivery of health care and targeted trials/interventions with relevance to health disparities, and if widely implemented, morbidities and mortality related to lupus could be drastically reduced in African-Americans.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Name acceptable measures of lupus disease activity List the components of an effective stress management program Discuss the utility of linking a psychosocial stress intervention with clinical measures of disease activity in African American lupus patients in reducing adverse outcomes.

Keyword(s): Interventions, Quality of Life

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee the MUSC SLE Clinic database and have made linkages to our patients possible for numerous investigators, including Dr. Williams.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.