IMPROVING HYPERTENSION CARE FOR INNER CITY MINORITIES

提出的是一个多方面的计划，以改善长期血压 (BP)控制在一个主要是非洲裔美国人，低社会经济地位的社区， 大城市。该计划的组成部分将包括一个社区 教育运动，对私人医生的教育干预， 以及对高血压患者护理过程的重大修改， 医疗保健系统是目标的最大单一提供者 区干预区将与类似社区进行比较， 城市的另一部分由不同的私人和公共服务 提供商 干预前后随机抽样1050人， 将从每个地理区域选出18-74人， 该方案在减少不受控制的 高血压社区干预将侧重于改善 意识和需要维持治疗。私人医生的 干预措施将侧重于促进长期病人 坚持。公立医院诊所/系统部分将：1）教育 2）为工作的穷人建立夜间诊所，3） 提供量身定制的患者教育计划， 敏感，不需要上课出勤，和4）实施一项计划 在公立医院急救中心， 未被发现的高血压或高血压未得到定期护理。 努力，包括社区卫生中心的提醒和跟踪 社会工作者，将被用来保持病人积极的治疗 程序. 调查人员有能力执行 程序.社区干预将由合作研究者指导 德克萨斯南方大学（大津），一所历史悠久的黑人大学 位于干预区，在以下方面具有丰富的经验： 社区外展对私人医生的干预将是 由贝勒医学院的研究人员指导， 在医生群体中建立了临床信誉。的 贝勒大学的调查人员也直接监督 在哈里斯县医院区（HCHD）提供护理的医生 公共医疗体系。HCHD还深深致力于 项目，并已在所有规划的高水平代表 这一提案的阶段。

Proposed is a multifaceted program to improve long-term blood pressure (BP) control in a predominantly African-American, low SES community of a large city. Components of the program will include a community education campaign, an educational intervention for private physicians, and major modifications in the process of care for hypertensives in a health care system that is the largest single provider to the target area. The intervention area will be compared to a similar community in another part of the city which is served by different private and public providers. Pre and post-intervention random samples of 1050 persons ages 18-74 will be selected from each geographical area to assess the effectiveness of the program in reducing the prevalence of uncontrolled hypertension. The community intervention will focus on improving awareness and need to maintain treatment. The private physician intervention will focus on strategies for promoting long-term patient adherence. The public hospital clinic/systems component will: 1) educate providers, 2) institute an evening clinic for the working poor, 3) provide tailored patient education programs which are culturally sensitive and do not require class attendance, and 4) implement a program in the public hospital emergency center to identify and refer patients with undetected hypertension or hypertension not under regular care. Efforts, including reminders and follow-up by community health center social workers, will be used to keep patients active in treatment programs. The investigators are in a strong position to implement the program. The community intervention will be directed the co-investigator from Texas Southern University (TSU), an historically Black university located in the intervention area, who has extensive experience in community outreach. The intervention toward private physicians will be directed by investigators from Baylor College of Medicine who have established clinical credibility in the physician community. The investigators from Baylor also have direct supervision over the physicians who provide care in the Harris County Hospital District (HCHD) public health care system. The HCHD is also deeply committed to the project and has had a high level of representation in all the planning phases for this proposal.