Promoting Self-Management in Low Income African Americans Living With Hypertension
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      The specific study aims are to: 1) examine differences between an Ecological Nursing Case
      Management (ENCM) treated group and a comparison group on self-efficacy, SM behaviors, and
      health status to establish effect sizes needed for a future large randomized controlled
      trial; 2) explore the dose-response of specific elements of the ENCM intervention; and 3)
      examine moderating effects of gender and perceived stress on the intervention effect. This is
      a two-group randomized experimental study with repeated measurements. Clients in the
      treatment group (n=25) will receive the individualized ENCM and those in the comparison group
      (n=25) will receive usual clinic care. Data will be collected at baseline, 1, 3, and 6 months
      to capture the immediate, short and longer term effects of the intervention.
    

Detailed description: 
      Health outcomes of chronically ill low-income adults are costly in both fiscal and human
      terms. Although advances have been made in understanding how nurse case management (NCM) can
      contribute to self-management (SM) behaviors, the factors that contribute to sustained SM
      behaviors in low-income African American populations are not well understood. This study will
      examine the impact of Ecological Nurse Case Management (ENCM) on self-management behaviors,
      health status, and self-efficacy of poor, chronically ill, African American adults. In
      addition, we will explore moderating effects to determine if the ENCM intervention is
      differentially effective based on gender or perceived stress. The study will use the UWM
      Automated Community Health Information System, a relational electronic health record, to
      document the individualized ECNM intervention and dose of the intervention. The specific
      study aims are to: 1) examine differences between an ENCM treated group and a comparison
      group on self-efficacy, SM behaviors, and health status to establish effect sizes needed for
      a future large randomized controlled trial; 2) explore the dose-response of specific elements
      of the ENCM intervention; and 3) examine moderating effects of gender and perceived stress on
      the intervention effect. This is a two-group randomized experimental study with repeated
      measurements. Clients in the treatment group (n=25) will receive the individualized ENCM and
      those in the comparison group (n=25) will receive usual clinic care. Data will be collected
      at baseline, 1, 3, and 6 months to capture the immediate, short and longer term effects of
      the intervention. Acknowledging the small sample size, mixed models for repeated measures
      data (at baseline and M1, 3, and 6 post-intervention) will be fit to interactions involving
      moderating variables of gender and stress. The ENCM intervention draws on evidence that given
      the proper tools (i.e., knowledge, skills and support), individuals can learn to better
      self-manage their symptoms on a day to day basis and better utilize the health care resources
      available to them.
    

Intervention name(s): Ecological Nurse Case Management
Intervention type(s): Behavioral
Intervention description(s): The Ecological Nurse Case Management (ENCM) intervention allows for individualized case management based on client preferences through mutual goal setting and client choice points, nursing assessments, the nurse's analytic decision-making process and critical thinking, and nursing actions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention