Support for Cardiovascular Health in African American Primary Care Patients

Study Overview
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Brief Summary
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Project Overview: Poor hypertension control has dire consequences for the African-American population who suffer greater death and disability from heart disease, stroke, and renal failure than whites. To reduce these health disparities it is critical to promote of a healthy lifestyle in regard to diet, exercise, adherence to medications, as well as other behaviors. However, physicians usually fail to address lifestyle behaviors in the context of the harried patient visit. Therefore, the investigators hypothesized that the investigators could reduce cardiovascular risk by providing additional support to persons with poorly controlled hypertension through phone calls from trained peer patients and visits to an office support staff member. Study Design: A single-blind, randomized, controlled trial in 280 African-American primary care patients aged 40-75 with poorly controlled hypertension (HTN). The intervention group receives a practice-based team intervention that combines peer coach with office staff (i.e., medical assistant or licensed practice nurse) visits to address lifestyle challenges. Both intervention and control groups receive informational materials and healthy soul food recipes from the American Heart Association. The 6 month intervention alternates monthly phone calls from peer coaches about lifestyle behavioral changes with office-based visits with the support staff member during which patients review and discuss low literacy slide shows about healthy behaviors as well as examine their personal cardiovascular risk profile.

Official Title
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Peer and Health Educator Support for Cardiovascular Health in African-American Primary Care Patients

Conditions
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Cardiovascular Diseases, Blood Pressure

Intervention / Treatment
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* Behavioral: Peer Coach Phone Calls
* Behavioral: Health Educator Visits
* Other: written materials


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: African American Uncontrolled Hypertension at least 3 practice visits in the past 2 years One lipid panel since 2005 Exclusion Criteria: No recent lipid panel Kept less than 60% of primary care visits in the prior 2 years

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Case<br> | Behavioral: Peer Coach Phone Calls<br>* Subjects will receive 3 phone calls from a trained peer coach over 6 months.<br>Behavioral: Health Educator Visits<br>* Subjects will meet 2 times with a trained health educator in the practice<br>Other: written materials<br>* Subjects will receive written material and brochures and a cookbook from the American Heart Association addressing healthy lifestyle<br>|
| Active Comparator: Control<br> | Other: written materials<br>* Subjects will receive written material and brochures and a cookbook from the American Heart Association addressing healthy lifestyle<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Greater reduction in CHD risk in case group vs. control |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 5mm reduction in systolic blood pressure in case group |  | 6 months |