Achieving Blood Pressure Control Together Study (ACT)

Johns Hopkins University

Status: Completed

Conditions: Hypertension

Treatments: Behavioral: Community Health Worker (CHW) Intervention; Behavioral: Communication Skills Training; Behavioral: Problem Solving Skills Training

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01902719

1P50HL105187 (U.S. NIH Grant/Contract)

NA_00078591

Details and patient eligibility

About

African Americans represent a particularly vulnerable subgroup of persons with hypertension, as they are more likely than Whites to have hypertension, equally as likely to be aware of it and to be treated for it, but less likely to achieve blood pressure control while receiving treatment. African Americans are also more likely than Whites to suffer end organ damage as a result of hypertension. Patients' hypertension self-management behaviors (including adherence to prescribed care, self-blood pressure monitoring, lifestyle changes, and shared medical decision-making) represent a cornerstone of hypertension therapy. Evidence suggests some African Americans with hypertension may experience difficulties carrying out positive self-management behaviors, in part due to cultural beliefs and practices, knowledge and perceptions regarding the nature and consequences hypertension, and lack of systems to support ongoing engagement in prescribed care within their communities. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses.

The goal of this study is to rigorously test the effectiveness of hypertension self-management interventions that engage African American patients, their families, and their community-level resources to improve African American patients' blood pressure.

We hypothesize patients' hypertension control rates may be improved when combining community health worker self-management support with other types of hypertension self-management skills training.

Enrollment: 159 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 18 years and above
• African American/Black
• English speaking
• Two Blood Pressure values >=140/>=90 in 6 months prior
• Seen at East Baltimore Medical Center

Exclusion criteria

• 18 years and less
• Non African American/Black
• Not English speaking
• Pregnant

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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159 participants in 3 patient groups

Community Health Worker (CHW) Intervention

Experimental group

Description:

Participants randomized to this arm will receive the Community Health Worker Intervention that will include training in the use of home blood pressure machine, education on diet and exercise, and one-on-one support to assist with overcoming barriers to hypertension control (e.g., accessing healthcare, social and community services).

Treatment:

Behavioral: Community Health Worker (CHW) Intervention

CHW Intervention and Communication Skills Training

Experimental group

Description:

Participants randomized to this arm will receive the Community Health Worker Intervention and a communication skills training to partner with their physician providers in a way that encourages their greater involvement and shared decision-making with their physicians about hypertension care.

Treatment:

Behavioral: Communication Skills Training

Behavioral: Community Health Worker (CHW) Intervention

CHW and Problem Solving Skills Training

Experimental group

Description:

Participants randomized to this arm will receive the Community Health Worker Intervention and the Problem Solving Skills Training Intervention, a 9-week peer based self-management intervention to help patients improve their hypertension self-management by learning and employing skills to overcome their self-identified barriers to self-management.

Treatment:

Behavioral: Problem Solving Skills Training

Behavioral: Community Health Worker (CHW) Intervention