Using Lay Health Advisors to Improve Hypertension Management

MetroHealth Medical Center

Status: Terminated

Conditions: Hypertension

Treatments: Behavioral: Lay Health Advisor

Study type: Interventional

Funder types: Other

Identifiers

NCT03515005

IRB18-00038

Details and patient eligibility

About

Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension.

Full description

Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. Health providers generally lack the skills and resources to address social contextual factors (i.e. health and community services, social networks, social stressors, physical environment, and economic resources) that influence management of hypertension. Instead, providers tend to focus on adjusting antihypertensive medication prescriptions and exhorting patients to exercise and eat better. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension. Helping patients address these barriers may lead not only to improved blood pressure but also to increased survival, reduced organ damage, and decreased health care costs. This project may also serve as a model of healthcare delivery innovation that could be used to address other health disparity conditions.

Enrollment: 69 patients

Sex: All

Ages: 18 to 64 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• At least 2 outpatient blood pressures with systolic >140 or diastolic >90 mm Hg in last 6 months. Separate occurrences at least 1 day apart
• Age 18-59 years
• Non-diabetic
• Preserved kidney function (glomerular filtration rate >60 ml/min)
• English speaking

Exclusion criteria

• Mentally incompetent
• Pregnant
• Terminal illness
• Active substance abuse
• Documented coronary, peripheral arterial, or cerebrovascular disease

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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69 participants in 2 patient groups

Lay Health Advisors

Experimental group

Description:

Intervention patients will meet monthly in small groups with a trained Lay Health Advisor.

Treatment:

Behavioral: Lay Health Advisor

Usual Care

No Intervention group

Description:

Control patients will receive usual care from their doctors.