Effectiveness of an Anger and Stress Management Program on Reducing Blood Pressure Levels in Youth

Impact of LifeSkills Training on Blood Pressure in Youth

High blood pressure can often be caused by stress or anxiety. This study will evaluate a school-based stress and anger management program that aims to lower blood pressure and anger levels among high school students.

Study Overview

• Status: Completed
• Conditions: Cardiovascular Diseases; Hypertension
• Intervention / Treatment: Behavioral: Williams LifeSkills Stress and Anger Management Workshop; Behavioral: High school classes

Detailed Description

High blood pressure can be caused by many factors, including stress, anxiety, diabetes, kidney disease, or obesity. In many people, there is no identifiable cause for their high blood pressure; this is known as essential hypertension (EH). Increasingly, children are being diagnosed with high blood pressure, which may lead to an increased risk of developing EH as adults. Therefore, the need exists for an effective blood pressure reduction program targeted toward youth. Research has shown that improving people's abilities to manage stress and anger reduces their risk of developing high blood pressure and heart disease. The Williams LifeSkills (WLS) workshop is a program that teaches people to cope with stressful situations. It has been shown to improve heart health, including blood pressure levels, in adults with cardiovascular disease. However, the effect of stress and anger management programs on blood pressure levels in youth has not been widely studied. Study researchers have developed and preliminarily tested a school-based anger and stress management WLS program. This study will evaluate the effectiveness of the school-based WLS program at reducing blood pressure and anger levels in high school students. If successful, this program could be implemented in schools across the country.

This study will enroll high school students. Participants will be randomly assigned to either a 12 lesson WLS program or a control group. Participants in the control group will attend regular high school classes. Participants in the WLS program will attend 12 sessions that will focus on coping skills to help manage stress and anger levels. At baseline, the end of the 12 lesson program, and follow-up visits 3 and 6 months later, participants will complete questionnaires on anger levels; life skills; hostility; stress; self-esteem; and attitudes toward school, teachers, and parents. They will also wear a blood pressure monitor for a 24-hour period.

• Study Type: Interventional
• Enrollment (Actual): 259
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Georgia
    • Augusta, Georgia, United States, 30901
      • Richmond County Board of Education Public Schools
    • Augusta, Georgia, United States, 30912
      • Medical College of Georgia - Georgia Prevention Institute
  • North Carolina
    • Durham, North Carolina, United States, 27705
      • Williams LifeSkills

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• High school student

Exclusion Criteria:

• History of any chronic illness or any chronic health problem requiring pharmacological treatment (e.g., asthma, sickle cell disease, epilepsy)
• Adolescents with ambulatory systolic blood pressure greater than the 95th percentile based on age, sex, and height at screening will be allowed to participate in the workshop but may be excluded from testing
• Unwilling to be assigned into a specific treatment group

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: 1; The 12-lesson Williams LifeSkills anger and stress management workshop (WLS) enhances awareness of thoughts and feelings in stressful situations, and provides training in evaluation, deflection, problem-solving, assertion, saying no, speaking, listening, empathy, and emphasizing positives.	Behavioral: Williams LifeSkills Stress and Anger Management Workshop; Williams LifeSkills Stress and Anger Management Workshop
Placebo Comparator: 2; Control group (will attend regular high school classes)	Behavioral: High school classes; The control group will attend regular high school classes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Reduction in day-time ambulatory systolic blood pressure	Measured at post-intervention after the 12 lesson program and at 3- and 6-month follow-up visits

Collaborators and Investigators

• Sponsor: National Heart, Lung, and Blood Institute (NHLBI)
• Collaborators: Williams LifeSkills
• Investigators: Principal Investigator: Vernon A. Barnes, PhD, Medical College of Georgia - Georgia Prevention Institute; Principal Investigator: Virginia P. Williams, PhD, Williams LifeSkills

Publications and helpful links

General Publications

• Barnes VA, Johnson MH, Williams RB, Williams VP. IMPACT OF WILLIAMS LIFESKILLS(R) TRAINING ON ANGER, ANXIETY AND AMBULATORY BLOOD PRESSURE IN ADOLESCENTS. Transl Behav Med. 2012 Dec 1;2(4):401-410. doi: 10.1007/s13142-012-0162-3. Epub 2012 Aug 30.
• Barnes VA, Williams VP, Williams RB. Effects of Williams LifeSkills training on anger reduction in African American adolescents. Psychosomatic Medicine. 2005;67:A53.
• Barnes VA, Williams VP, Williams RB, Johnson MH, Stevens AM, Shenbagarajan VP. Effect of Williams Lifeskills training on anger control in African American adolescents (abstract 014). Paper presented at: ISHIB2008: 23rd Annual International Interdisciplinary Conference on Hypertension and Related Cardiovascular Risk Factors in Ethnic Populations, 2008; New Orleans, LA.
• Barnes VA, Williams VP, Williams RB, Johnson MH, Murrell AS, Shenbagarajan VP, Dubert C. Williams Lifeskills® training lowers school-time ambulatory blood pressure in adolescents. Paper accepted for presentation at: Society of Behavioral Medicine Annual Meeting April 22-25, 2009; Montreal, Canada.
• Barnes VA, Williams VP, Williams RB, Shenbagarajan VP, Bentley DR, Johnson MH. Effect of Williams Lifeskills Training on Anger and Anxiety in Adolescents. Psychosomatic Medicine. 2010;72(3):A70.

Helpful Links

• website about Williams LifeSkills

Study record dates

Study Major Dates

• Study Start: April 1, 2007
• Primary Completion (Actual): May 1, 2009
• Study Completion (Actual): March 1, 2010

Study Registration Dates

• First Submitted: July 27, 2007
• First Submitted That Met QC Criteria: July 27, 2007
• First Posted (Estimate): July 30, 2007

Study Record Updates

• Last Update Posted (Estimate): July 12, 2016
• Last Update Submitted That Met QC Criteria: July 11, 2016
• Last Verified: March 1, 2013

More Information

Terms related to this study

• Keywords: Adolescents; Relaxation; Meditation; Blood Pressure; Coping Skills; Ambulatory Blood Pressure Monitoring; Systolic Blood Pressure; Diastolic Blood Pressure
• Additional Relevant MeSH Terms: Cardiovascular Diseases
• Other Study ID Numbers: 497; R42HL072644-02A2 (U.S. NIH Grant/Contract)