Community Health Worker Support for High Blood Pressure
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Florida
Disqualifiers: Focus group participation, others
No Placebo Group
Trial Summary
What is the purpose of this trial?The overall objective of this project is to assess the feasibility, acceptability, and appropriateness of adapted community health worker (CHW)-led implementation strategies designed to improve intake of fruits and vegetables and reduce BP among patients with hypertension experience food insecurity.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment CHW Education, CHW Education and Navigation for high blood pressure?
Research shows that community health workers (CHWs) are effective in improving care and health outcomes for chronic diseases like high blood pressure. They help by educating patients, providing counseling, and ensuring patients follow their treatment plans, which leads to better blood pressure control.
12345Is Community Health Worker support for high blood pressure safe for humans?
Community Health Worker programs have been used safely to help manage chronic diseases like high blood pressure and diabetes, especially in underserved communities. These programs focus on education, support, and improving access to care, and there is no evidence suggesting they are unsafe for humans.
12678How does the Community Health Worker Support treatment for high blood pressure differ from other treatments?
This treatment is unique because it involves community health workers (CHWs) who provide education and navigation support to help manage high blood pressure. CHWs play a crucial role in improving access to care, enhancing communication between patients and healthcare providers, and addressing social factors that affect health, which is different from traditional medical treatments that focus solely on medication.
124910Eligibility Criteria
This trial is for adults with high blood pressure (130-179 mm Hg systolic and 80-119 mm Hg diastolic), who don't have enough food, are diagnosed with hypertension, live in specific zip codes (32609, 32601, or 32641), and qualify for SNAP benefits. Those who helped develop the intervention by participating in a focus group cannot join.Inclusion Criteria
Your blood pressure is between 130/80 and 179/119.
You have trouble getting enough food to eat.
I have been diagnosed with high blood pressure.
+2 more
Exclusion Criteria
Participated in a focus group to develop the intervention
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Baseline Data Collection
Participants complete baseline data collection including a behavior survey and baseline biometrics
1 week
1 visit (in-person)
Treatment
Participants are randomly assigned to one of three arms: no strategy, CHW education, or CHW education and navigation, and receive respective interventions
4 weeks
Weekly visits (in-person or virtual depending on arm)
Follow-up
Participants are monitored for changes in blood pressure and carotenoid levels
4 weeks
Participant Groups
The study tests whether education from community health workers can help people eat more fruits and vegetables to lower their blood pressure. It's about finding out if this approach works well for those struggling to get enough food.
3Treatment groups
Experimental Treatment
Active Control
Group I: Community health worker provided education and NavigationExperimental Treatment1 Intervention
Participants will be invited to complete all the CHW education arm material and be offered a menu of optional services for personalization including: (1) transportation to the grocery store (weekly for 4 weeks), (2) culturally adapted hypertension-tailored cooking recipes, (3) a virtual cooking class with food delivered to their door led by community partner, (4) access to UF IFAS's online library of healthy food cooking videos, and (5) in-store education on food labels, grocery shopping, and food resource management skills through the Cooking Matters at the Store curricula.
Group II: Community health worker provided educationExperimental Treatment1 Intervention
Participants will be invited to meet with the CHW to learn about eating healthier to reduce blood pressure and enhance quantity and quality of life. The CHW will register individuals for SNAP benefits and educate them on how to use their benefits locally. As other resources exist, including food pantries, food distribution events, and Fresh Access Bucks (a federal program to double SNAP if spent on local produce at eligible farmers markets), the CHW will provide information on these services. The CHW will also provide a brief motivational educational session about eating healthier to reduce BP and enhance quality and quantity of life. The CHW will meet once for up to one hour with each participant.
Group III: No strategyActive Control1 Intervention
Individuals assigned to this arm with receive a publicly available color copy of the NIH's Healthy Blood Pressure for Healthy Hearts: Small Steps to Take Control Flyer available
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of FloridaGainesville, FL
Loading ...
Who Is Running the Clinical Trial?
University of FloridaLead Sponsor
National Center for Advancing Translational Sciences (NCATS)Collaborator
References
Community Health Workers in the Emergency Department-Can they Help with Chronic Hypertension Care. [2020]To review community health worker (CHW) interventions tailored for hypertension management and to determine if the emergency department (ED) population would benefit from such interventions.
Community health workers as interventionists in the prevention and control of heart disease and stroke. [2022]A considerable body of research indicates that community health workers (CHWs) are effective in improving chronic disease care and health outcomes. Much of the focus of cardiovascular research involving CHWs has been on hypertension because of its high prevalence and because it is a major risk factor for cardiovascular, cerebrovascular, and renal diseases. Adding CHWs to the patient-provider team has a beneficial effect on the quality of care for populations most in need. CHWs have contributed to significant improvements in community members' access to and continuity of care and adherence to treatment for the control of hypertension. CHWs assume multiple roles, including patient and community education, patient counseling, monitoring patient health status, linking people with health and human services, and enhancing provider patient communication and adherence to care. Current recommendations for CHWs to be interventionists on healthcare teams and in community-based research increase opportunities for CHWs to play an important role in eliminating disparities in heart disease and stroke. Adequate translation of research into clinical practice remains a major challenge, however. Addressing this issue, which has national implications, will require sustainable funding; appropriate reimbursement; enhanced efforts to incorporate CHWs into healthcare teams; better utilization of their skills; improved CHW supervision, training, and career development; policy changes; and ongoing evaluation, including a reporting of costs.
Linking community-based blood pressure measurement to clinical care: a randomized controlled trial of outreach and tracking by community health workers. [2019]This study assessed the effectiveness of enhanced tracking and follow-up services provided by community health workers in promoting medical follow-up of persons whose elevated blood pressures were detected during blood pressure measurement at urban community sites.
Development and Implementation of a Combined Nurse Care Manager and Community Health Worker Training Curriculum to Address Hypertension Disparities. [2023]The use of nurse care managers (CMs) and community health workers (CHWs) has demonstrated effectiveness in supporting improved blood pressure management among racially, ethnically, and socioeconomically minoritized populations. We partnered with a community advisory board (CAB) to develop a CM and CHW training curriculum and team-based collaborative care intervention to address uncontrolled hypertension. The objective of this study was to train CMs and CHWs to implement patient-centered techniques and address social determinants of health related to hypertension control. In partnership with a CAB, we developed and implemented a training curriculum for the CM/CHW collaborative care team. The training improved CM and CHW confidence in their ability to address medical and nonmedical issues that contribute to uncontrolled hypertension in their patients; however, preexisting norms and beliefs among CMs and CHWs created challenges with teamwork. The training curriculum was feasible and well-received. Additionally, the CMs' and CHWs' reactions provided insights to improve future collaborative care training and teamwork.
Approaches and outcomes of community health worker's interventions for hypertension management and control in low-income and middle-income countries: systematic review. [2023]To critically appraise the scope, content and outcomes of community health worker (CHW) interventions designed to reduce blood pressure (BP) in low-income and middle-income countries (LMICs).
Training and experience outperform literacy and formal education as predictors of community health worker knowledge and performance, results from Rongo sub-county, Kenya. [2023]There is a growing recognition that Community Health Workers are effective at improving health outcomes and expanding health access. However, the design elements that lead to high-quality Community Health Worker programing are relatively understudied. We looked at the predictors of Community Health Worker knowledge of obstetric and early infant danger signs as well as performance in achieving antenatal care and immunization uptake among their clients.
Evaluation of the training of Korean community health workers for chronic disease management. [2022]The use of community health workers (CHWs) or lay health advisors has been increasingly popular as an effective means of secondary prevention for cardiovascular health in hard-to-reach, underserved populations. Yet, published evaluations of the CHW training programs are rare. The purpose of this article is to report the results of an evaluation of a CHW training program for hypertension and diabetes management for Korean-American seniors. Forty-eight hours of training was developed and delivered to 12 Korean CHWs. Evaluation of the training program involved CHW surveys, trainer observation and debriefing and CHW focus groups. Testing of CHW knowledge showed that all CHWs met the minimum required knowledge level of 70%. Independent ratings by two trainer observations revealed that the overall CHW performance was satisfactory. Both CHW ratings and focus group data indicated that the training program met their expectation (average 9.3 on a 10-point scale) and was successful in empowering them to assume their role as a 'health initiator', 'health advertising agent' or 'health role model'. While this course is judged to be effective in general, future research is warranted to determine whether CHW provision of care and support will affect health outcomes in the target population.
Community Health Workers as Allies in Hypertension Self-Management and Medication Adherence in the United States, 2014. [2018]Rates of hypertension control remain low among underserved populations in the United States; moreover, disparities in hypertension-related cardiovascular disease death are increasing. Community health workers (CHWs) can address barriers to hypertension control among underrepresented and diverse populations. We identify unique roles CHWs play in hypertension self-management and medication adherence.
Effectiveness of a scalable group-based education and monitoring program, delivered by health workers, to improve control of hypertension in rural India: A cluster randomised controlled trial. [2020]New methods are required to manage hypertension in resource-poor settings. We hypothesised that a community health worker (CHW)-led group-based education and monitoring intervention would improve control of blood pressure (BP).
Effectiveness of community health workers in the care of people with hypertension. [2022]The contributions of community health workers (CHWs) in the delivery of culturally relevant programs for hypertension control have been studied since the 1970s. This systematic review examines the effectiveness of CHWs in supporting the care of people with hypertension.