IMPROVING HYPERTENSION CARE FOR INNER CITY MINORITIES

提出了一项多方面的改善长期血压的计划 (BP)在以非洲裔美国人为主的低社会经济地位社区的控制 一座大城市。该计划的组成部分将包括一个社区 教育活动，对私人医生的教育干预， 以及高血压患者护理过程中的重大修改 作为目标的最大单一提供者的医疗保健系统 区域。干预区将与#年的类似社区进行比较 城市的另一部分，由不同的私人和公共部门提供服务 供应商。1050名年龄段人群干预前后的随机抽样 将从每个地理区域中挑选18-74人来评估 该方案在降低失控流行率方面的有效性 高血压。社区干预将重点放在改善 意识和需要保持治疗。私家医生 干预将重点放在促进长期患者的策略上 坚持不懈。公立医院诊所/系统部分将：1)教育 提供者，2)为贫困劳动者建立夜间诊所，3) 提供具有文化内涵的量身定做的病人教育计划 敏感且不要求出勤，以及4)实施计划 在公立医院急救中心识别和转介患者 患有未被发现的高血压或未接受常规护理的高血压患者。 努力，包括社区卫生中心的提醒和跟进 社会工作者，将被用来使患者在治疗中保持活跃 程序。调查人员处于有利地位，可以实施 程序。社区干预将由合作调查员指导 来自德克萨斯南方大学(TSU)，一所历史悠久的黑人大学 位于干预区，谁有丰富的经验 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，他们有 在医生群体中建立了临床可信度。这个 贝勒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 公共卫生保健系统。人道主义事务高级专员办事处也坚定地致力于 项目，并在所有规划中都有很高的代表性 此提案的各个阶段。

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.