Southeastern Collaboration to Improve Blood Pressure Control
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      The central objective of this proposal is to rigorously compare two strategies designed to
      improve BP control in primary care practices serving rural Southeastern African Americans
      with low socioeconomic status (SES) living in the "Black Belt".

      In year 1, we're engaging community members (community members who have experience being
      community peer advisors or have high blood pressure) to develop the study interventions and
      protocols. In years 2-5, the investigators will test the interventions.

      Year 2-5, Aim 3: Enroll 80 practices and 25 African American patients with uncontrolled HTN
      at each practice (total n=2000) in a cluster-randomized, controlled, 4-arm pragmatic
      implementation trial to evaluate the three multi- component, multi-level functional
      interventions finalized in the UH2 phase compared with enhanced usual care.

      The study's 4 arms are:

        1. Enhanced Usual Care: Practices are provided with educational materials and tools to
           enhance patient care

        2. Peer Coaching: Patients enrolled in these practices will be matched with a peer coach.
           The peer coach helps the patient to set goals around self-management, including
           medications, home monitoring, and diet and exercise, and she helps the patient to
           strategize how to accomplish the goals, using motivational interviewing techniques

        3. Practice Facilitation: Practices randomized to this arm will work with a practice
           facilitator. Practice facilitation is a highly customized, staged approach to helping a
           practice to implement process and structural changes to enhance the quality of care and
           improve patient and staff satisfaction

        4. Peer coaching and practice facilitation: Practices randomized to this arm will receive
           both the peer coach intervention and the practice facilitation intervention. Practice
           facilitators and peer coaches will receive the same training for this hybrid
           intervention, but the practice facilitator change packet will add examples of activities
           that integrate peer coaches.
    


Intervention name(s): Practice Facilitation; Peer Coach; Enhanced usual care
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction; Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months.; Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Other intervention name(s): Taking Control of Your Health
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment