Clinical trial NCT02874547: Community Health Workers Using Patient Stories to Support Hypertension Management
Official title: Community Health Workers Using Patient Stories to Support Hypertension
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hypertension
Lead sponsor: University of Massachusetts, Worcester
Sponsor class: OTHER
First posted: 2016-08-22
Enrollment: 171
Sex: ALL
Minimum age (years): 30
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: Community Health Workers (CHWs) using patient stories to support hypertension management is a randomized controlled trial to evaluate the implementation of a CHW-delivered culturally appropriate storytelling intervention for english and spanish-speaking patients diagnosed with hypertension who receive care at community health center settings.

Detailed description: Community Health Workers (CHWs) using patient stories to support hypertension (HTN) management is a CHW-delivered culturally appropriate storytelling intervention for patients diagnosed with HTN. We will develop and test interactive videos presenting stories of patients who have successfully made changes enhancing blood pressure control; and integrate this new tool with a CHW approach to management of hypertension. This two site, two-armed randomized controlled trial aims to recruit 252 english and spanish speaking patients with uncontrolled HTN. All participants are randomized to receive five visits (two in-person and 3 telephone calls) with CHWs either immediately (intervention condition (I)) or 6 months after enrollment (delayed intervention (DI)). Intervention participants receive the intervention immediately and DI participants receive print materials at enrollment and are telephoned 4-6 months after enrollment to schedule an in-person visit at the health enter to begin receiving the intervention protocol.

Eligibility criteria: Inclusion Criteria:

* English and Spanish speaking patients
* Male or female between the ages of 30 and 80
* Diagnosis of HTN and uncontrolled HTN, defined as (a) having an average systolic BP greater than or equal to 140 and /or diastolic BP greater than or equal to 90 over the past 12 months or (b) most recent BP reading within the previous 6 months as systolic BP greater than or equal to 140 and /or diastolic BP greater than or equal to 90.
* Willingness to be randomized to either intervention or delayed intervention

Exclusion Criteria:

* Pregnant women
* Patients planning to leave the Community Health Center in the next year
* Adults unable to consent

Primary outcomes:
measure: changes in systolic and diastolic BP (SBP and DBP)
timeFrame: 6 months
Secondary outcomes:
measure: Reduce sodium intake
timeFrame: 6 months
measure: Increased physical activity
timeFrame: 6 months
measure: Greater medication adherence
timeFrame: 6 months
measure: Blood Pressure maintenance
timeFrame: 12 months
Other outcomes:
Locations:
city: Lowell
country: United States
facility: Lowell Community Health Center
state: Massachusetts
city: Worcester
country: United States
facility: Family Health Center of Worcester
state: Massachusetts
Study officials:
affiliation: University of Massachusetts, Worcester
name: Warren Ferguson, M.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010 May 26;303(20):2043-50. doi: 10.1001/jama.2010.650.
citation: Ostchega Y, Dillon CF, Hughes JP, Carroll M, Yoon S. Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004. J Am Geriatr Soc. 2007 Jul;55(7):1056-65. doi: 10.1111/j.1532-5415.2007.01215.x.
citation: McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of medicare coverage. Ann Intern Med. 2009 Apr 21;150(8):505-15. doi: 10.7326/0003-4819-150-8-200904210-00005.
citation: Swider SM. Outcome effectiveness of community health workers: an integrative literature review. Public Health Nurs. 2002 Jan-Feb;19(1):11-20. doi: 10.1046/j.1525-1446.2002.19003.x.
citation: Houston TK, Allison JJ, Sussman M, Horn W, Holt CL, Trobaugh J, Salas M, Pisu M, Cuffee YL, Larkin D, Person SD, Barton B, Kiefe CI, Hullett S. Culturally appropriate storytelling to improve blood pressure: a randomized trial. Ann Intern Med. 2011 Jan 18;154(2):77-84. doi: 10.7326/0003-4819-154-2-201101180-00004.
citation: Hargraves JL, Bonollo D, Person SD, Ferguson WJ. A randomized controlled trial of community health workers using patient stories to support hypertension management: Study protocol. Contemp Clin Trials. 2018 Jun;69:76-82. doi: 10.1016/j.cct.2018.04.004. Epub 2018 Apr 12.