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Engaging Native Hawaiian/Pacific Islanders and Activating Communities to Take Steps (ENACTS)

Washington State University logo

Washington State University

Status

Completed

Conditions

Hypertension

Treatments

Behavioral: ENACTS

Study type

Interventional

Funder types

Other

Identifiers

NCT03484364
U54MD011240 (U.S. NIH Grant/Contract)
U54MD011240 127687

Details and patient eligibility

About

Our Specific Aims are:

  1. At the individual level, to compare within-person change in BP and secondary outcomes between the intervention and control groups.
  2. At the family level, to evaluate ENACTS' effects on BP and secondary outcomes as within-person change in family members who provide primary support, and as mean change in other adult family members who are not directly engaged in the intervention.
  3. At the policy level, to evaluate the intervention's ability to influence grocery store policy on clearly identifying foods that are low in sodium or high in potassium, some of which might not be easily identified with existing labels (e.g., fresh produce). ENACTS combines empirically supported elements of existing programs, thus increasing its probability of success. It aligns with the American Heart Association's call for multilevel prevention.

Full description

This study adapts an existing educational intervention to address self-management of hypertension in NHPIs. The multilevel 6-month intervention - "Engaging NHPIs and Activating Communities to Take Steps" (ENACTS) - will use peer-facilitated, self-care BP education delivered weekly for 8 weeks emphasizing healthy diet, traditional NHPI foods, adherence to medication, and encouragement to increase physical activity and stop smoking; with text messaging to boost adherence. ENACTS will be implemented as a randomized controlled trial at 3 community sites serving NHPIs in the Puget Sound area of Washington. 270 NHPI adults (90 per site) with a self-reported physician diagnosis of hypertension and elevated BP measured at enrollment will be randomized to either ENACTS or usual care.

The primary outcome is change in systolic BP. Secondary outcomes are food purchasing behaviors (online ordering, grocery receipts); medication adherence; social support; smoking cessation; and GIS data on daily energy expenditure. The study will use a Geographic Information Systems (GIS) mobile phone app to track participants. Outcomes will be measured at baseline, weekly, at 8 weeks, and at 6 months. The study will also examine change in household food purchasing patterns, enhanced family support for BP control, and BP improvement among family members. A subset of intervention participants and family members will be invited to participate in a program that uses personal photographs for narrative art projects to promote labeling of healthy foods by local retail outlets.

Enrollment

182 patients

Sex

All

Ages

18+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Self-reported physician diagnosis of hypertension and/or type 2 diabetes confirmed by a prescription for an anti-hypertensive medication and/or type 2 diabetes medication;
  • Self-reported NHPI race;
  • *Age 18 years and older at enrollment;
  • Measured systolic BP ≥ 140 mmHg on enrollment; measured baseline fasting glucose >125
  • reliable internet access
  • computer or Smartphone
  • current email address
  • *Ability to understand written and spoken English; and
  • *Ability and willingness to follow all study protocols.

Exclusion criteria

  • Pregnant or planning on becoming pregnant throughout the course of the study;
  • Currently undergoing dialysis or treatment for a terminal illness;

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

182 participants in 2 patient groups

Intervention Group
Experimental group
Description:
The ENACTS intervention is four peer-facilitated educational classes delivered over 8 weeks focused on hypertension self-management.
Treatment:
Behavioral: ENACTS
Waitlist Group
No Intervention group
Description:
Usual care and $50 in groceries every other week for 8 weeks.

Trial contacts and locations

1

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Central trial contact

Odile Madesclaire; Denise A Dillard

Data sourced from clinicaltrials.gov

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