The Heart Healthy Lenoir project--an intervention to reduce disparities in hypertension control: study protocol.
The Heart Healthy Lenoir project--an intervention to reduce disparities in hypertension control: study protocol.
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DOI：
10.1186/1472-6963-13-441
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发表时间：
2013-10-25
影响因子：
2.8
通讯作者：
Heart Healthy Lenoir Research Team
中科院分区：
文献类型：
--
作者：
Halladay JR;Donahue KE;Hinderliter AL;Cummings DM;Cene CW;Miller CL;Garcia BA;Tillman J;DeWalt D;Heart Healthy Lenoir Research Team
血压控制方面的种族差异是公认的;然而，低健康素养（LHL）对血压的影响却较少受到关注。基于办公室的干预措施是由反复的患者，实践和社区利益相关者的输入创建的，并逐步推出，可能有助于解决高血压控制中的这些差异。本文描述了我们的研究方案。采用社区参与式研究（CBPR）方法，我们设计并实施了一项队列研究，包括实践水平和患者水平的干预，以加强北卡罗来纳州东部农村地区初级保健实践中高血压患者的护理和支持。该研究分为形成阶段和持续2.5年的实施阶段。我们的主要护理增强活动包括社区健康教练的整合，在临床决策中使用家庭血压监测，标准化护理提供流程，以及努力提高药物依从性。主要结果包括总体血压变化、不同种族（非裔美国人与白色人）的血压差异变化和健康素养水平（低健康素养与高健康素养）。在初级保健实践环境中使用基于社区的参与式方法有助于使患者和实践工作人员和提供者参与研究工作，并改变实践以支持高血压护理。在不同层面开展了各种做法，但迄今为止，在实施和反复改进干预措施方面取得了进展。ClinicalTrials.gov NCT01425515。
Racial disparities in blood pressure control are well established; however the impact of low health literacy (LHL) on blood pressure has garnered less attention. Office based interventions that are created with iterative patient, practice and community stakeholder input and are rolled out incrementally, may help address these disparities in hypertension control. This paper describes our study protocol. Using a community based participatory research (CBPR) approach, we designed and implemented a cohort study that includes both a practice level and patient level intervention to enhance the care and support of patients with hypertension in primary care practices in a rural region of eastern North Carolina. The study is divided into a formative phase and an ongoing 2.5 year implementation phase. Our main care enhancement activities include the integration of a community health coach, using home blood pressure monitoring in clinical decision making, standardizing care delivery processes, and working to improve medication adherence. Main outcomes include overall blood pressure change, the differential change in blood pressure by race (African American vs. White) and health literacy level (low vs. higher health literacy). Using a community based participatory approach in primary care practice settings has helped to engage patients and practice staff and providers in the research effort and in making practice changes to support hypertension care. Practices have engaged at varying levels, but progress has been made in implementing and iteratively improving upon the interventions to date. ClinicalTrials.gov NCT01425515.
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影响因子：
1.3
作者：
White, WB;Anwar, YA
通讯作者：
Anwar, YA
影响因子：
2.8
作者：
Sheridan SL;Draeger LB;Pignone MP;Keyserling TC;Simpson RJ Jr;Rimer B;Bangdiwala SI;Cai J;Gizlice Z
通讯作者：
Gizlice Z
影响因子：
2.1
作者：
Savage, Christine L.;Xu, Yin;Anthony, Jean Spann
通讯作者：
Anthony, Jean Spann
影响因子：
2.2
作者：
Bosworth, HB;Olsen, MK;Oddone, EZ
通讯作者：
Oddone, EZ
影响因子：
8.3
作者：
BURT, VL;WHELTON, P;LABARTHE, D
通讯作者：
LABARTHE, D