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 非洲裔美国人的高血压尽管有证据表明 这表明家庭血压（BP）远程监测可能有优势， 需要进行更多的研究，因为：a）我们不知道 这种策略对BP的长期控制;和B）我们不知道的机制 通过远程监护降低血压，实现血压控制。因此，委员会认为， 这项“新研究者”主导的随机对照试验的具体目标 是：a）比较仅常规护理与家庭远程监护加常规护理， 确定哪一种对血压变化的影响最大， B）确定干预措施的影响程度 通过饮食习惯、体力活动水平、体重 损失，酒精摄入，抗高血压药物治疗方案的依从性， 或与初级保健提供者联系。我们的研究是第一个 采用基于社区而不是基于诊所的招聘策略， 从而扩大获得护理的机会。健康非裔美国人英语 年龄> 18岁，SBP > 140 mmHG， DBP > 90 mmHG（除非个体自我认定为糖尿病患者或患有 心脏病发作史，则SBP> 130 mmHG，DBP > 85 mmHG） 方便地从指定的社区站点中选择。参与者将被 随机分配到两组之一，这两组按使用或不使用 抗高血压药物：A组-家庭远程监护加常规护理;或 B组-仅常规治疗。A组受试者将接受常规护理加 12个月的每周远程监测和15次远程辅导， 根据JNC-VI提供有关生活方式改变的信息 指南拟议的干预措施旨在突出 参与者的高血压，提供了采取行动和帮助他们的提示 来学习该采取什么行动。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， 抗高血压药物治疗方案的依从性，以及与 初级保健提供者）将在基线和3、6和12个月时收集。 分析将包括一个一般的混合线性模型方法，以重复 测量MANOVA和结构方程增长曲线建模。

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.