Community Partnership to Examine Racial and Ethnic Differences in Health Care for Hypertension and Diabetes (CHAMPP)

Harvard Medical School (HMS and HSDM)

Status: Completed

Conditions: Hypertension; Diabetes Mellitis

Treatments: Other: Combination Intervention to Include Medical Practice Improvement and Patient Education and Support; Behavioral: Patient Education and Support; Behavioral: Medical Practice Improvement

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00379652

410

R21HL083859-01 (U.S. NIH Grant/Contract)

1R21HL083859-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Hypertension and diabetes are among the most common chronic diseases in the United States. Racial and ethnic minority groups are more at risk for these diseases than the Caucasian population. This study will attempt to identify factors that contribute to racial and ethnic differences in hypertension and diabetes care among minority patients of community health centers (CHCs). This information will be used to design and implement programs to improve quality of care in these communities.

Full description

Hypertension and diabetes are the primary contributors to today's high rates of heart disease and stroke, which are the first and third leading causes of death in the United States, respectively. African Americans and Hispanics have a higher risk of developing hypertension and diabetes than do Caucasians. They are also less likely to know that they have high blood pressure, are more prone to organ damage, and are more likely to die as a result of these chronic conditions. A significant number of African Americans and Hispanics are uninsured and receive care through publicly supported CHCs. It is important to identify factors that contribute to healthcare differences among the lower income, uninsured, and minority populations that are typically served by CHCs. In this study, a collaborative partnership will be developed between CHCs, health service research organizations, and academic researchers. The goal of the study is to examine the barriers that minority CHC patients face in receiving appropriate hypertension and diabetes care.

This study will develop a collaborative partnership between various health organizations and seven CHCs located in Boston neighborhoods that have a large percentage of African American and Hispanic residents. Researchers will conduct focus groups with CHC patients who are receiving care for hypertension or diabetes. CHC staff members will be interviewed to collect information regarding the relationship between CHC organizational structure and disparities in heart disease risk factors among minority patients with hypertension or diabetes. Researchers will then develop, implement, and evaluate a patient- and CHC-focused intervention aimed at reducing the cardiovascular risks of minority patients at four CHCs in Boston.

Enrollment: 1,204 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Diabetes
• Hypertension, as diagnosed by the average of two or more blood pressure measurements taken during two or more study visits following an initial screening
• Race is 'Black' or ethnicity is 'Hispanic'
• Patient at participating Community Health Center

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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1,204 participants in 4 patient groups

A

Active Comparator group

Description:

Patient-based intervention

Treatment:

Behavioral: Patient Education and Support

B

Active Comparator group

Description:

Health center-based intervention

Treatment:

Behavioral: Medical Practice Improvement

C

Active Comparator group

Description:

Combination of patient and health center-based intervention

Treatment:

Other: Combination Intervention to Include Medical Practice Improvement and Patient Education and Support

D

No Intervention group

Description:

Control group: Neither patient-based nor center-based intervention