DVDs About Blood Pressure

This project consists of two phases: (1) Collecting of stories and creating a stories DVD;
and (2) delivering the DVD in a randomized control trial (RCT). Both phases are described
below.

The investigators will make two DVDs of African-American Veterans who will tell their
success stories with controlling hypertension (HTN). The investigators want to help
African-American Veterans control their hypertension by showing them stories that are
interesting and that they can identify with, as well as giving them information about ways
they can manage hypertension in their everyday lives. This is important because a
disproportionate number of minority patients, including Veterans, have poorly controlled
blood pressure. By showing them stories, rather than using more traditional methods of
health education, the investigators hope to overcome some typical barriers to HTN control
among the African-American population, including: lower levels of health literacy and
numeracy, less trust in the medical system, and different (non-medical) models to explain
their illness.

The Veteran storytellers will come from three VA sites (Charleston, Chicago, and
Philadelphia) and their stories will be chosen based on (1) the proven effectiveness of the
strategies they suggest for controlling BP and (2) how authentic they are, or how much they
will "ring true" with the experiences of other Veterans, including their struggles and
lessons learned.

After the DVD is complete, the investigators will conduct a randomized control trial to
evaluate how effective it is in helping vets control their hypertension: 780
African-American vets with uncontrolled hypertension, from the same three VA sites, will
participate. Half of them will watch the "Stories" DVD the investigators created; and the
other half will watch a control, a DVD with the same medical information but without the
narrative component. The investigators will measure their blood pressure (BP) just before
they watch the DVD and again six months later. The investigators hypothesize that, six
months after enrollment, the Veterans who watched the "Stories" DVD will have greater
reduction in BP, as compared with those who watch the control. The investigators will also
test the "Stories" DVD's impact on medication adherence and HTN management behaviors.

Inclusion Criteria:

- African-American

- Diagnosis of HTN

- Uncontrolled BP as defined by BP >140/90 twice in the preceding 12 months

Exclusion Criteria:

- active substance abuse

- severe mental illness

- cognitive disabilities that might prevent them from actively or reliably
participating in the interviews