Abstract Body: INTRODUCTION: Our research uses community-engagement to adapt the AHA heart health (HH) promotion model for marginalized communities of Black Americans with among the highest rates of hypertension morbidity and mortality. The model promotes HH by improving positive psychological health, supporting essential health behaviors, and using relevant measures of community risk factors.

HYPOTHESIS: Positive psychological health predicts HH behaviors in a community with high rates of hypertension.

METHODS: Cross-sectional survey data were collected and analyzed to test the associations between community-based measures of positive psychological health (Black identity, spirituality, environmental wellbeing, peace), negative psychological health (ongoing problems, anxiety, internalized anger, and depression), detrimental processes (inflammatory body pain), and life essential behaviors (nonsmoking, walking, fruit-vegetables, check BP). Statistical models, including latent variable models and generalized linear models, estimated psychometrics and variable associations.

RESULTS: Participants (N=493) were Black American adults (M=46YRS) primarily female (62.77%), single (59%), HS diploma or higher degree (92%), less than half (43.4%) with income < $10,000. Across gender, age, and health status, the majority of the participants (82.53%) met AHA criteria for either elevated or high BP. Environmental well-being predicted physical activity (β=0.033, p=0.04) and exercise (β=0.045, p<0.001). Participants in latent classes with higher levels of stress, depression, and anxiety were more likely to use tobacco (mid- vs low-risk class, OR=2.269, high- vs low-risk, OR=2.876, both p<.001), and negative psychological health was also correlated with more body pain (chronic stress, r=0.169; depression, r=0.102; anxiety, r=0.089; all p<0.001). Environmental injustice (e.g., promotes poor health) was associated with higher levels of stress (OR=1.13, 95% CI:1.02–1.25) and poorer self-rated health (OR=1.23, 95% CI:1.10–1.38) but was not associated with BP.

CONCLUSIONS: Our results support community adaptation of the HH model for Black Americans. In addition to treatment resistance, it seems reasonable to speculate that extremely high community rates of hypertension might signal unaddressed upstream social determinants of heart health. Community relevant measures of positive psychological health may better predict risk factors associated with morbidity and mortality rates.