We Talk About Our Hypertension

描述(申请人提供)：尽管越南是一个中低收入国家，但它一直在经历向非传染性疾病日益流行的发展中国家的流行病学过渡。在越南，心血管疾病(CVD)的关键危险因素要么在上升，要么处于令人担忧的水平，特别是高血压(HTN)。因此，除非采取有效的预防和控制措施，否则越南男子和妇女患心血管疾病的负担将继续增加。拟议项目的目标是开发一种多方面的以社区为基础的干预措施，基于一种已被证明在其他少数族裔人群中有效的讲故事方法，以控制越南成年人的高血压(BP)。我们正在提议一项试点的整群随机试验，以测试大规模有效性试验的可行性。四个社区(共有100名高血压患者)将被随机分为干预组(n=2)和对照组(n=2)(按人口规模匹配)；HTN患者将根据其居住社区被随机分配到干预或控制状态。符合条件和同意的干预组参与者将通过观看训练有素的卫生工作者提供的HTN(讲故事)患者的故事DVD，获得与HTN相关的文化和扫盲方面的适当教育材料和面对面的会议。DVD将包括不受控制的HTN对健康的影响，克服HTN控制的障碍，以及坚持处方药物和改变生活方式的故事。干预社区的初级卫生保健提供者也将通过加强HTN控制的培训和教育来增强能力。在被分配到常规护理的社区，人们将观看对比DVD，其中只包含HTN指南，并且将是非互动格式，没有讲故事或补充材料，并接受当地社区卫生中心目前提供的HTN相关教育。该项目解决了越南严重的临床和公共卫生问题，实施了第一项以社区为基础的研究，对这一人群进行了文化素养适当的HTN干预。

DESCRIPTION (provided by applicant): Although being a low-middle income country, Vietnam has been experiencing an epidemiologic transition to that of a developing country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in Vietnamese men and women unless effective prevention and control measures are put in place. The objectives of the proposed project are to develop a multi-faceted community-based intervention, based on a Storytelling method which has been shown to be effective in other minority populations, for the control of elevated blood pressure (BP) in adults in Vietnam. We are proposing a pilot cluster-randomized trial to test the feasibility of a large scale effectiveness trial. Four communities (wih a total of 100 hypertensive patients) will be randomized into either an intervention (n=2) or comparison group (n=2) (matching on population size); persons with HTN will be randomly assigned to intervention or control status based on their community of residence. Eligible and consenting participants in the intervention group will receive culturally and literacy appropriate HTN related educational materials and in-person sessions through viewing DVDs of stories from patients with HTN (Storytelling) given by trained health workers. The DVDs will include stories about the health consequences of uncontrolled HTN, overcoming barriers to HTN control, and adherence to prescribed medication and lifestyle changes. Primary health care providers in the intervention communities will also be empowered through intensive training and education on HTN control. In communities assigned to usual care, persons will view comparison DVDs, which only contain guidelines on HTN, and will be in a non-interactive format without storytelling or supplementary materials, and receive HTN related education as currently provided at local community health centers. This project addresses a serious clinical and public health problem in Vietnam by implementing the first community-based study using a culturally-literacy appropriate HTN intervention for this population.