Walk Together: A Family-Based Intervention for Hypertension In African Americans

The University of Texas System (UT)

Status: Completed

Conditions: Hypertension; Family Relations

Treatments: Behavioral: Walk Together

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05671302

STU-2022-0568

R21MD017658-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The goal of this study is to determine the feasibility and acceptability of a novel family-based hypertension self-management intervention, Walk Together, adapted from an existing empirically-supported dyadic intervention, for implementation in primary care.

Full description

Hypertension is the driving risk factor for disparities in mortality and life expectancy between African Americans and Whites. Hypertension self-management (including blood pressure monitoring, diet, exercise, and other lifestyle changes) is critical for improving hypertension control, and prior interventions have emphasized promoting patient-level behavior change to improve self-management adherence. Though family members make substantial contributions to hypertension self-management for African Americans, family support is consistently underutilized by current hypertension self-management interventions. Family-based interventions for improving self-management are effective for other chronic conditions, including for African Americans. Evidence has demonstrated the unique and important role of family support in African Americans' hypertension management, and African Americans' preferences for the direct involvement of family in hypertension interventions. The study team will develop a family-based hypertension self-management intervention ("Walk Together") for African Americans with uncontrolled hypertension that integrates community-based participatory perspectives in the specifics of the intervention. The study team will pilot trial the culturally-adapted intervention in a primary care setting in order to examine the feasibility and acceptability of the Walk Together protocol.

Enrollment: 62 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Black or African American
• Age 18 to 75
• Two blood pressure values ≥ 130/ ≥ 80 in 12 months prior
• Available family support person to join the intervention who agrees to participate
• English-speaking

Exclusion criteria

• Family support person is under the age of 18
• Documented cognitive impairment in patient's medical record
• Presence of severe psychiatric condition (i.e., current psychotic disorder or suicidality)
• Participation in prior hypertension health education intervention
• Prior participation in formative study activities (i.e., study focus groups)

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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62 participants in 1 patient group

Walk Together

Experimental group

Description:

Walk Together involves four sessions delivered in patients' primary care clinic over approximately two months. Sessions are dyadic (i.e., all sessions include the patient and a family support person), last 30-90 minutes, and are delivered by a trained family therapist. The intervention is a culturally-response, family-based intervention that is strengths-based and includes components of integrative behavioral couples therapy and motivational interviewing. The goals of the intervention are to (a) optimize family support and communication, (b) improve hypertension knowledge, (c) enhance self-management goal-setting, and (d) increase shared problem-solving to address self-management adherence barriers. Environmental barriers to adherence are also addressed consistent with standard care.

Treatment:

Behavioral: Walk Together