Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: A randomized clinical trial

Patti L Ephraim, Felicia Hill-Briggs, Debra Roter, Lee R Bone, Jennifer Wolff, LaPricia Lewis-Boyer, David Levine, Hanan Aboumatar, Lisa A Cooper, Stephanie J. Fitzpatrick, Kimberly A Gudzune, Michael C. Albert, Dwyan Monroe, Michelle Simmons, Debra Hickman, Leon Purnell, Annette Fisher, Richard Matens, Gary J. Noronha, Peter J. FaganHema C Ramamurthi, Jessica M. Ameling, Jeanne Charlston, Tanyka S. Sam, Kathryn Anne Carson, Nae Yuh Wang, Deidra Crews, Raquel Charles Greer, Valerie Sneed, Sarah J. Flynn, Nicole DePasquale, Leigh Boulware

Research output: Contribution to journalArticle

Abstract

Background: Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. Methods/design: We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12. months. Discussion: Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control.

Original languageEnglish (US)
Pages (from-to)370-382
Number of pages13
JournalContemporary Clinical Trials
Volume38
Issue number2
DOIs
StatePublished - 2014

Fingerprint

African Americans
Randomized Controlled Trials
Blood Pressure
Hypertension
Self Care
Primary Health Care
Chronic Disease
Communication
Delivery of Health Care

Keywords

  • Community health worker
  • Hypertension
  • Self-management

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)

Cite this

Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study : A randomized clinical trial. / Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra; Bone, Lee R; Wolff, Jennifer; Lewis-Boyer, LaPricia; Levine, David; Aboumatar, Hanan; Cooper, Lisa A; Fitzpatrick, Stephanie J.; Gudzune, Kimberly A; Albert, Michael C.; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J.; Fagan, Peter J.; Ramamurthi, Hema C; Ameling, Jessica M.; Charlston, Jeanne; Sam, Tanyka S.; Carson, Kathryn Anne; Wang, Nae Yuh; Crews, Deidra; Greer, Raquel Charles; Sneed, Valerie; Flynn, Sarah J.; DePasquale, Nicole; Boulware, Leigh.

In: Contemporary Clinical Trials, Vol. 38, No. 2, 2014, p. 370-382.

Research output: Contribution to journalArticle

Ephraim, Patti L ; Hill-Briggs, Felicia ; Roter, Debra ; Bone, Lee R ; Wolff, Jennifer ; Lewis-Boyer, LaPricia ; Levine, David ; Aboumatar, Hanan ; Cooper, Lisa A ; Fitzpatrick, Stephanie J. ; Gudzune, Kimberly A ; Albert, Michael C. ; Monroe, Dwyan ; Simmons, Michelle ; Hickman, Debra ; Purnell, Leon ; Fisher, Annette ; Matens, Richard ; Noronha, Gary J. ; Fagan, Peter J. ; Ramamurthi, Hema C ; Ameling, Jessica M. ; Charlston, Jeanne ; Sam, Tanyka S. ; Carson, Kathryn Anne ; Wang, Nae Yuh ; Crews, Deidra ; Greer, Raquel Charles ; Sneed, Valerie ; Flynn, Sarah J. ; DePasquale, Nicole ; Boulware, Leigh. / Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study : A randomized clinical trial. In: Contemporary Clinical Trials. 2014 ; Vol. 38, No. 2. pp. 370-382.
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abstract = "Background: Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. Methods/design: We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12. months. Discussion: Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control.",
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T2 - A randomized clinical trial

AU - Ephraim, Patti L

AU - Hill-Briggs, Felicia

AU - Roter, Debra

AU - Bone, Lee R

AU - Wolff, Jennifer

AU - Lewis-Boyer, LaPricia

AU - Levine, David

AU - Aboumatar, Hanan

AU - Cooper, Lisa A

AU - Fitzpatrick, Stephanie J.

AU - Gudzune, Kimberly A

AU - Albert, Michael C.

AU - Monroe, Dwyan

AU - Simmons, Michelle

AU - Hickman, Debra

AU - Purnell, Leon

AU - Fisher, Annette

AU - Matens, Richard

AU - Noronha, Gary J.

AU - Fagan, Peter J.

AU - Ramamurthi, Hema C

AU - Ameling, Jessica M.

AU - Charlston, Jeanne

AU - Sam, Tanyka S.

AU - Carson, Kathryn Anne

AU - Wang, Nae Yuh

AU - Crews, Deidra

AU - Greer, Raquel Charles

AU - Sneed, Valerie

AU - Flynn, Sarah J.

AU - DePasquale, Nicole

AU - Boulware, Leigh

PY - 2014

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