Dual-Language B-MORE for Hypertension

• Behavioral: B-MORE (Brief Mindfulness-Oriented Recovery Enhancement) (Behavioral): B-MORE is a validated, two-hour adaptation of the evidence-based MORE program. It retains each of the three, core therapeutic elements of the traditional MORE program (mindfulness, reappraisal, savoring) and is organized for delivery in two, 1-hour sessions.

Primary outcomes

• Feasibility of the B-MORE intervention for Stress [The expected time frame is from baseline to study completion, an average of 10 weeks.]: The feasibility of the B-MORE intervention for managing stress in hypertensive patients will be assessed using recruitment metrics. Specifically, feasibility will be based on the recruitment rate, defined as the number of participants recruited and enrolled per week. Feasibility will also be based on session attendance metrics, defined as the percentage of participants who complete the first B-MORE session and the second B-MORE session. Finally, feasibility will be based on retention rates, defined as the percentage of participants completing all treatment sessions and study surveys.
• Feasibility of the B-MORE intervention for Blood Pressure [The expected time frame is from baseline to study completion, an average of 10 weeks.]: The feasibility of the B-MORE intervention for managing blood pressure in hypertensive patients will be assessed using recruitment metrics. Specifically, feasibility will be based on the recruitment rate, defined as the number of participants recruited and enrolled per week. Feasibility will also be based on session attendance metrics, defined as the percentage of participants who complete the first B-MORE session and the second B-MORE session. Finally, feasibility will be based on retention rates, defined as the percentage of participants completing all treatment sessions and study surveys.

Secondary outcomes

• Treatment Acceptability for the B-MORE intervention for Stress [Measured through participant self-report at the completion of the B-MORE program (immediately post-intervention and at 2-week and 6-week follow-up assessments).]: The acceptability of the B-MORE intervention for managing stress in hypertensive patients will be based on participant self-report at the completion of the B-MORE program and at the 2- and 6-week follow-up assessments. More specifically, a 4-item Treatment Acceptability and Preferences questionnaire rated on a 5-point Likert Scale ("Not at all" to "Very Much") will be used for treatment acceptability. The scores from these 4 items will be summed and averaged to calculate an average score between 1 and 5, with a higher average scores indicating greater treatment acceptability.
• Treatment Acceptability for the B-MORE intervention for Blood Pressure [Measured through participant self-report at the completion of the B-MORE program (immediately post-intervention and at 2-week and 6-week follow-up assessments).]: The acceptability of the B-MORE intervention for managing blood pressure in hypertensive patients will be based on participant self-report at the completion of the B-MORE program and at the 2- and 6-week follow-up assessments. More specifically, a 4-item Treatment Acceptability and Preferences questionnaire rated on a 5-point Likert Scale ("Not at all" to "Very Much") will be used for treatment acceptability. The scores from these 4 items will be summed and averaged to calculate an average score between 1 and 5, with a higher average scores indicating greater treatment acceptability.
• Treatment Expectancy for the B-MORE Intervention [Measured through participant self-report at the completion of the B-MORE program (immediately post-intervention).]: Treatment expectancy for the B-MORE intervention will be based on participant self-report at the completion of the B-MORE program and at the 2- and 6-week follow-up assessments. More specifically, a 4-item Credibility/Expectancy Questionnaire rated on a sliding scale from "Not at all" to "Very Much" will be used for treatment expectancy and credibility, with higher ratings indicating greater treatment expectancy.
• Treatment Satisfaction with the B-MORE Intervention [Measured through participant self-report at the completion of the B-MORE program (immediately post-intervention and at the 2- and 6-week follow up points).]: Treatment satisfaction with the B-MORE intervention will be based on participant self-report at the completion of the B-MORE program and at the 2- and 6-week follow-up assessments. More specifically, a 3-item questionnaire with qualitative questions on the patient experience (e.g., "Was the program accessible? If not, what barriers did you encounter?" and "What were the best or most useful elements of the program?") will be used for treatment satisfaction.

Other outcomes

• Change in Psychological Stress (Physiological) [Expected time frame is baseline to study completion, approximately 10 weeks. Heart rate and stress-related measures recorded daily.]: Physiological data, including heart rate variability (HRV) collected via Garmin watches.
• Adverse Effects of the B-MORE Intervention [Measured through participant self-report at the completion of the B-MORE program (immediately post-intervention).]: Adverse effects of the B-MORE intervention will be based on participant self-report at the completion of the B-MORE program and at the 2- and 6-week follow-up assessments. More specifically, a 2-item measure on unwanted or unpleasant experiences during or after the training sessions (e.g., "Did you experience any unwanted or unpleasant experiences during or after the training?") will be used for evaluating adverse effects.
• Change in Diastolic Blood Pressure [Measured at baseline, before and after each intervention session, immediately post-intervention, and at 2-week and 6-week follow-up assessments. Daily BP measurements will also be taken.]: Self-measured diastolic blood pressure using a provided blood pressure cuff.
• Change in Systolic Blood Pressure [Measured at baseline, before and after each intervention session, immediately post-intervention, and at 2-week and 6-week follow-up assessments. Daily BP measurements will also be taken.]: Self-measured systolic blood pressure using a provided blood pressure cuff.
• Change in State Anxiety [Expected time frame is 2 weeks. Measured immediately before and after each of the 2 intervention sessions.]: Changes in state anxiety will be based on a single-item self-report question on acute anxiety symptoms ("How nervous, anxious, or on edge do you feel right now?"). It will be rated on a 0-10 numeric rating scale, with 0 being no anxiety at all and 10 being anxiety as bad as you can imagine. It will be measured immediately before and immediately after the B-MORE sessions.
• Change in Trait Anxiety [Expected time frame is baseline to study completion, approximately 10 weeks. Measured at baseline, immediately post-intervention, and at 2-week and 6-week follow-up assessments.]: Changes in trait anxiety will be based on the Generalized Anxiety Disorder-2, a 2-item questionnaire rated on 4-point Likert scale from "Not at all" to "Nearly every day." The scores from these 2 items will be summed to calculate a total score between 0 and 6, with higher scores (3 or higher) indicating greater anxiety symptoms. It will be completed at baseline, immediately post-intervention, and at the 2- and 6-week follow-up assessments.
• Change in Trait Depression [Expected time frame is baseline to study completion, approximately 10 weeks. Measured at baseline, immediately post-intervention, and at 2-week and 6-week follow-up assessments.]: Changes in trait depression will be based on the Depression with the Patient Health Questionnaire-2, a 2-item questionnaire rated on 4-point Likert scale from "Not at all" to "Nearly every day." The scores from these 2 items will be summed to calculate a total score between 0 and 6, with higher scores (3 or higher) indicating greater depression symptoms. It will be completed at baseline, immediately post-intervention, and at the 2- and 6-week follow-up assessments.
• Change in Quality of Life [Expected time frame is baseline to study completion, approximately 10 weeks. Measured at baseline, immediately post-intervention, and at 2-week and 6-week follow-up assessments.]: Changes in quality of life will be based on the WHO-5 Well-Being Index, a 5-item questionnaire rated on a 0-5 numeric rating scale, with 0 being "At no time" and 5 being "All of the time." The scores from all 5 items will be summed to calculate a raw score between 0 and 25 and then multiplied to calculate a percentage score between 0 and 100, with higher percentages indicating greater mental well-being. It will be completed at baseline, immediately post-intervention, and at the 2- and 6-week follow-up assessments.
• Change in Hypertension Symptomology [Expected time frame is baseline to study completion, approximately 10 weeks. Measured at baseline, immediately post-intervention, and at 2-week and 6-week follow-up assessments.]: Changes in hypertension symptomology will be based on the Mini Cuestionario de Calidad de Vida en Hipertensión Arterial (MINICHAL), a 16-item questionnaire rated on a 4-point Likert scale from "No, not at all" (0) to "Yes, a lot" (3). Scores from items 1-10 will be summed to calculate a total score for the State of Mind Domain. This total score will range from 0 to 30, with higher scores indicating worse mental well-being due to hypertension. Scores from items 11-16 will be summed to calculate a total score for the Somatic Manifestations Domain. This total score will range from 0 to 18, with higher scores indicating more severe physical symptoms due to hypertension. It will be completed at baseline, immediately post-intervention, and at the 2- and 6-week follow-up assessments.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Age ≥18
* Having self-reported hypertension (BP ≥ 140/90)
* Understanding English or Spanish instructions fluently

Exclusion Criteria:

* Known or planned pregnancy in the next 3 months assessed via self-report
* Cognitive impairment preventing completion of study procedures.
* Have previous, formal mindfulness training (e.g., MBSR)
* Other unstable illness judged by medical staff to interfere with study involvement.