URBAN AFRICAN-AMERICAN COMMUNITY HYPERTENSION CONTROL

城市非裔美国人社区高血压控制

• 批准号: 3369934
• 负责人: DAVID MORRIS LEVINE
• 金额: $ 49.92万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 1997-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3369934
• 关键词: African American; adult human (21+); antihypertensive agents; behavior modification; cardiovascular disorder chemotherapy; cardiovascular disorder prevention; clinical trials; community health services; counseling; health behavior; health education; human subject; human therapy evaluation; prognosis; social support network; therapy compliance; urban area

The objective of this population based clinical trial is to investigate whether a health education program, developed in partnership with the community and delivered by nurse supervised community health workers (CHWs), lowers high blood pressure (HBP) in inner city African American adults. This two and a half year intervention trial seeks to extend and test the generalizability of our prior work, in a similar inner city African American community, which demonstrated the efficacy of planned health education programs that are culturally-sensitive, community-based and owned, and built upon appropriate behavioral and community activation theory and principles, in improving the control of HBP and decreasing related morbidity and mortality. Participants will be recruited from households in neighborhood blocks randomly assigned to a more less intensive educational-behavioral intervention. Both groups will receive usual medical care, community HBP education, and HBP patient education materials. In addition, the more intensive group will receive 1) individualized educational counseling sessions with the CHW to increase understanding of HBP and to address barriers to control of HBP; 2) outreach and follow-up to address inadequate health care resources and health behavior related skills through interim monitoring and education "booster" sessions; and 3) mobilization of social support from a family member/friend identified by the participant as the primary source of daily reinforcement. Five hundred males and five hundred females will be recruited. Statistical analysis will focus on BP change in all adults with HBP on randomized blocks whether or not they participated in either of the intervention groups (program effectiveness), as well as BP change in all adults participating in the two interventions regardless of their level of compliance (intervention efficacy). In addition, the analysis will focus on differences in the two groups regarding individuals' adherence to HBP lowering recommendations to enter/re-enter care, remain in care, modify lifestyle, and take HBP medication. Multiple regression will be done to determine the contribution of the changes in the major independent variables (perceived barriers, use of health care resources and health care skills, and social support) to changes in the outcome and intervening variables which include adherence to HBP lowering recommendations. This population based study is significant because it offers a multidisciplinary, community HBP control program to help close the gap in health status for African Americans.

这项以人群为基础的临床试验的目的是研究 是否一个健康教育项目，是与 由护士监督的社区卫生工作者提供 (CHWS)，降低市中心非裔美国人的高血压(HBP) 成年人。这项为期两年半的干预试验旨在延长和 在类似的内城测试我们之前工作的可推广性 非裔美国人社区，这证明了计划的有效性 对文化敏感、以社区为基础的健康教育计划 拥有，并建立在适当的行为和社区激活的基础上 改善高血压病控制和降低血压的理论和原则 相关发病率和死亡率。 参与者将从邻近街区的家庭中招募 随机分配到更不密集的教育行为 干预。这两组人都将接受常规的医疗护理，社区高血压 教育，以及高血压患者教育材料。此外，越多 集中小组将接受1)个性化的教育咨询 与CHW举行会议，以增进对HBP的了解并解决 控制高血压的障碍；2)外展和后续行动 卫生保健资源不足和健康行为相关技能 通过临时监测和教育“助推器”会议；以及3) 动员下列家庭成员/朋友的社会支持 将学员作为日常强化的主要来源。五 将招募100名男性和500名女性。统计 分析将重点放在随机治疗所有成人高血压患者的血压变化上 阻止他们是否参与了这两次干预 小组(计划有效性)以及所有成年人的血压变化 参与这两项干预，无论其水平如何 依从性(干预效果)。此外，分析将重点放在 论两组人群在个体对HBP的依从性上的差异 降低进入/重新进入护理、继续接受护理、修改 生活方式，并服用高血压药物。将进行多重回归以 确定重大自主变更的贡献度 变量(感知障碍、卫生保健资源的使用和健康 护理技能和社会支持)对结果和 包括坚持降低HBP在内的中介变量 建议。这项基于人群的研究意义重大，因为它 提供多学科、社区HBP控制程序，以帮助 非裔美国人健康状况的差距。