NURSE-MANAGED BP TELEMONITORING WITH AFRICAN AMERICANS

描述：迫切需要找到更好的方法来控制和治疗 非裔美国人的高血压。尽管有一些证据表明 暗示家庭血压(BP)远程监护可能有好处， 有必要进行更多的研究，因为：a)我们不知道 这一战略对BP的长期控制；以及b)我们不知道其机制 通过远程监护降低血压，实现血压控制。因此， 这项由“新研究者”主导的随机对照试验的具体目的 是：a)仅将常规护理与家庭远程监护加上常规护理进行比较 确定以下哪种方法对血压变化的影响最大 基线；以及b)确定干预效果的程度 受饮食习惯、体力活动水平、体重变化的影响 失落，酒精摄入，抗高血压药物治疗的依从性， 或与初级保健提供者联系。我们的研究是其首批研究之一 以社区为基础而不是以诊所为基础的招聘策略， 从而扩大获得护理的机会。其他健康的非裔美国人英语 男性和女性(n=400)，年龄为18岁，SBP；140毫米汞柱和 DBP&>90毫米汞柱(除非个人自认为患有糖尿病或患有 有心脏病发作史，则SBP&GT；130毫米汞柱，DBP&>85毫米汞) 从指定的社区站点中方便地选择。参与者将是 随机分配到两组之一，按使用或不使用 抗高血压药物：A组：家庭远程监护加常规护理； B组：常规护理。A组的参赛者将接受常规护理和 每周远程监测12个月和15次远程监测， 根据JNC-VI提供有关生活方式调整的信息 指导方针。拟议的干预措施旨在增加 对于参与者的高血压，提供了采取行动的提示和帮助 来了解应该采取什么行动。数据(血压变化 基线，饮食习惯，体力活动水平，体重减轻，酒精摄入量， 对抗高血压药物治疗的依从性，以及与 将在基线、3、6和12个月时收集。 分析将包括一种通用的混合线性模型方法，以重复 测量马诺瓦和结构方程增长曲线模型。

DESCRIPTION: There is an urgent need to find better ways to control and treat high blood pressure in African Americans. Although there is some evidence to suggest there may be advantages to home blood pressure (BP) telemonitoring, there is a need for more research since: a) we do not know about the effects of this strategy on long-term control of BP; and b) we do not know the mechanisms by which telemonitoring works to lower BP and achieve BP control. Accordingly, the specific aims of this "new investigator"-led randomized controlled trial are to: a) compare usual care only with home telemonitoring plus usual care to determine which has the greatest effect on change in blood pressure from baseline; and b) determine the extent to which the effects of the intervention are mediated by changes in dietary habits, physical activity level, weight loss, alcohol intake, compliance with an antihypertensive medication regimen, or contact with a primary care provider. Our study is one of the first of its kind using a community-based rather than clinic-based recruitment strategy, thereby expanding access to care. Otherwise healthy African American English speaking men and women (n=400) who are > 18 years with a SBP > 140 mmHG and a DBP > 90 mmHG (unless the individual self-identifies as a diabetic or with a history of a heart attack, then SBP> 130 mmHG, DBP > 85 mmHG) will be conveniently selected from specified community sites. Participants will be randomly assigned to one of two groups that are stratified by use or non-use of antihypertension medication: Group A--home telemonitoring plus usual care; or Group B--usual care only. Participants in Group A will receive usual care plus weekly telemonitoring for 12 months and 15 sessions of telecounseling which provide information about lifestyle modifications in accordance with JNC-VI guidelines. The proposed intervention is intended to increase the saliency of the hypertension for participants, provide a cue to take action and assist them to learn about what actions to take. Data (change in blood pressure from baseline, dietary habits, physical activity level, weight loss, alcohol intake, compliance with an antihypertensive medication regimen, and contact with a primary care provider) will be collected at baseline and at 3, 6 and 12 months. Analysis will include a general mixed linear model approach to repeated measures MANOVA and structural equation growth curve modeling.