The Association of Neighborhood Gene-Environment Susceptibility with Cortisol and Blood Pressure in African-American Adults.

BACKGROUND: African-American adults are disproportionately affected by stress-related chronic conditions like high blood pressure (BP), and both environmental stress and genetic risk may play a role in its development. PURPOSE: This study tested whether the dual risk of low neighborhood socioeconomic status (SES) and glucocorticoid genetic sensitivity interacted to predict waking cortisol and BP. METHODS: Cross-sectional waking cortisol and BP were collected from 208 African-American adults who were participating in a follow-up visit as part of the Positive Action for Today's Health trial. Three single-nucleotide polymorphisms were genotyped, salivary cortisol samples were collected, and neighborhood SES was calculated using 2010 Census data. RESULTS: The sample was mostly female (65 %), with weight classified as overweight or obese (M BMI = 32.74, SD = 8.88) and a mean age of 55.64 (SD = 15.21). The gene-by-neighborhood SES interaction predicted cortisol (B = 0.235, p = .001, r (2) = .036), but not BP. For adults with high genetic sensitivity, waking cortisol was lower with lower SES but higher with higher SES (B = 0.87). Lower neighborhood SES was also related to higher systolic BP (B = -0.794, p = .028). CONCLUSIONS: Findings demonstrated an interaction whereby African-American adults with high genetic sensitivity had high levels of waking cortisol with higher neighborhood SES, and low levels with lower neighborhood SES. This moderation effect is consistent with a differential susceptibility gene-environment pattern, rather than a dual-risk pattern. These findings contribute to a growing body of evidence that demonstrates the importance of investigating complex gene-environment relations in order to better understand stress-related health disparities.

Qualitative developmental research among low income African American adults to inform a social marketing campaign for walking.

BACKGROUND: This study describes the development of a social marketing campaign for increasing walking in a low income, high crime community as part of the Positive Action for Today's Health (PATH) trial. METHODS: Focus groups were conducted with 52 African American adults (ages 18 to 65 yrs), from two underserved communities to develop themes for a social marketing campaign to promote walking. Participants responded to questions concerning social marketing principles related to product, price, place, promotion, and positioning for increasing neighbourhood walking. RESULTS: Focus group data informed the development of the campaign objectives that were derived from the "5 Ps" to promote physical and mental health, social connectedness, safety, and confidence in walking regularly. Focus group themes indicated that physical and mental health benefits of walking were important motivators. Walking for social reasons was also important for overcoming barriers to walking. Police support from trusted officers while walking was also essential to promoting safety for walking. Print materials were developed by the steering committee, with a 12-month calendar and door hangers delivered to residents' homes to invite them to walk. Pride Stride walks empowered community walkers to serve as peer leaders for special walking events to engage new walkers. CONCLUSIONS: Essential elements for developing culturally tailored social marketing interventions for promoting walking in underserved communities are outlined for future researchers.