Collaboration Oriented Approach to Controlling High blood pressure (COACH)

项目总结 背景资料。高血压在成年人中很常见，尽管它是可以控制的，但40%的人 那些患有高血压的人没有得到控制，仍然处于心脏病发作、中风和 肾衰竭。控制高血压可以通过药物治疗和改变行为来实现 和生活方式，包括减肥、改变饮食、增加活动、减少酒精摄入量和停止 烟草使用。这些需要自我管理和监测血压；新的工具，如网络 应用程序可以帮助提供这种支持，但需要标准化的方法来反映以下建议 控制血压，并更好地让高血压患者参与进来。我们的创新将结合 用基于标准的CDS工具改善血液的社会认知理论和行为经济学 压力控制。 进球了。该提案的目标是实现面向患者的可共享、可互操作和可扩展的临床 高血压的决策支持。我们的目标是完善和实施一种面向患者的 面向自适应协作的高血压控制方法(Coach CDS System in 3 多样化的设置，使用实施科学和患者参与来最大限度地提高效率。然后，我们 将进行一项混合方法研究，包括使用实施科学和 社会认知理论，以测试应用程序在降低血压方面的有效性；并最终开发 强大、可共享、可互操作的机制，以帮助进一步传播和实施患者- 面对CDS。我们的方法是将现有的、可互操作的CDS实施到3个不同的站点，然后 进行包含定性和定量成分的随机对照试验，以了解有效性 和实施问题。我们将与包括患者在内的广泛群体合作，进一步 传播我们的作品。

PROJECT SUMMARY Background. High blood pressure is common in adults, and – despite the fact it can be controlled – 40% of those with high blood pressure do not have it controlled and remain at high risk for heart attack, strokes, and kidney failure. Controlling high blood pressure can be achieved through medications and changes in behavior and lifestyle, including losing weight, changing diets, increasing activity, reducing alcohol intake, and stopping tobacco use. These require self-management and monitoring of blood pressure; new tools such as web applications can help provide this support, but need standardized approaches to reflect recommendations for blood pressure control and to better engage those with high blood pressure. Our innovation will combine social cognitive theory and behavioral economics with a standards based CDS tool to improve blood pressure control. Goal. The goal of the proposal is to implement sharable, interoperable, and scalable patient-facing clinical decision support for high blood pressure. Our objectives are to refine and implement a patient-facing, adaptable Collaboration Oriented Approach to Controlling High blood pressure (COACH CDS system in 3 diverse settings, using implementation science and patient engagement to maximize effectiveness. Then, we will perform a mixed methods study including a randomized controlled trial using implementation science and social cognitive theory to test effectiveness of the application at lowering blood pressure; and finally to develop robust, sharable, interoperable mechanisms to aid in further dissemination and implementations of patient- facing CDS. Our methods will be to implement existing, interoperable CDS into 3 different sites and then perform a randomized controlled trial with qualitative and quantitative components to understand effectiveness and implementation issues. We will collaborate with a broad number of groups – including patients – to further disseminate our work.