Community Outreach to African-Americans: Implementations for Controlling Hypertension

Implementation to Increase Blood Pressure Control: What Works? (J Brettler and K Reynolds, Section Editors)
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Abstract

Purpose of Review

The purpose of this review is to examine the impact and effectiveness of community interventions for controlling hypertension in African-Americans. The questions addressed are as follows: Which salient prior and current community efforts focus on African-Americans and are most effective in controlling hypertension and patient-related outcomes? How are these efforts implemented and possibly sustained?

Recent Findings

The integration of out-of-office blood pressure measurements, novel hypertension control centers (i.e., barbershops), and community health workers improve hypertension control and may reduce the excess hypertension-related complications in African-Americans. Several community-based interventions may assist effectiveness of clinical care teams, decrease care barriers, and improve adherence.

Summary

A multifaceted, tailored, multidisciplinary community-based approach may effectively reduce barriers to blood pressure control among African-Americans. Future research should evaluate the long-term benefits of community health workers, barbershops as control centers, and out-of-office blood pressure monitoring upon control and eventually on morbidity and mortality.

Keywords

African-American Hypertension Community Blood pressure Cardiovascular disease 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. 1.
    Long E, Ponder M, Bernard S. Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern United States. Patient Educ Couns. 2017 May 31;100(5):1000–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Ferdinand KC, Nasser SA. Disparate cardiovascular disease rates in African Americans: the role of stress related to self-reported racial discrimination. Mayo Clin Proc. 2017;92(5):689–92. ElsevierCrossRefPubMedGoogle Scholar
  3. 3.
    •• Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017. American College of Cardiology and American Heart Association (AHA) guidelines for the detection, prevention, management and treatment of high blood pressure, the 2017 guideline.Google Scholar
  4. 4.
    •• Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015–2016. NCHS data brief, no 289. Hyattsville, MD: National Center for Health Statistics; 2017. This report presents updated estimates for the prevalence and control of hypertension in the USA for 2015–2016.Google Scholar
  5. 5.
    •• Gu A, Yu Y, Desai RP, Argulian E. Racial and ethnic differences in antihypertensive medication use and blood pressure control among US adults with hypertension. Circ Cardiovasc Qual Outcomes. 2017;10:e003166. African-American and Hispanic patients demonstrated poorer hypertension control compared with whites, with differences being more pronounced in younger and uninsured patients.CrossRefPubMedGoogle Scholar
  6. 6.
    •• Mueller M, Purnell TS, Mensah GA, Cooper LA. Reducing racial and ethnic disparities in hypertension prevention and control: what will it take to translate research into practice and policy? Am J Hypertens. 2015;28(6):699–716.  https://doi.org/10.1093/ajh/hpu233. In-depth review of the multiple barriers to reducing disparities in BP control from individual to population-based factors.CrossRefPubMedGoogle Scholar
  7. 7.
    •• Anderson ML, Peragallo Urrutia R, O’Brien EC, NM ALP, Christian AJ, Kaltenbach LA, et al. Outcomes of a multi-community hypertension implementation study: the American Heart Association’s Check. Change. Control. program. J Clin Hypertens. 2017;19(5):479–87. Description of an exemplary American Heart Association Check. Change. Control. program as a novel community-based initiative that demonstrated reduction in BP among 18 urban, community sites.CrossRefGoogle Scholar
  8. 8.
    Target: BP Improvement Program, 2017. https://targetbp.org/blood-pressure-improvement-program/. Page accessed: December 11, 2017
  9. 9.
    Hanlin RB, Asif IM, Wozniak G, Sutherland SE, Shah B, Yang J, et al. Measure Accurately, Act Rapidly, and Partner With Patients (MAP) improves hypertension control in medically underserved patients: Care Coordination Institute and American Medical Association Hypertension Control Project Pilot Study results. J Clin Hypertens. 2018:1–9.Google Scholar
  10. 10.
    Centers for Disease Control and Prevention. Best practices for cardiovascular disease prevention programs: a guide to effective health care system interventions and community programs linked to clinical services. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2017.Google Scholar
  11. 11.
    Guide to Community Preventive Services. TFFRS—cardiovascular disease: interventions engaging community health workers. https://www.thecommunityguide.org/content/tffrs-cardiovascular-disease-interventions-engaging-community-health-workers. Page last updated: August 23, 2017. Page accessed: December 11, 2017
  12. 12.
    Morgan AU, Grande DT, Carter T, Long JA, Kangovi S. Penn Center for Community Health Workers: step-by-step approach to sustain an evidence-based community health worker intervention at an academic medical center. Am J Public Health. 2016;106(11):1958–60.  https://doi.org/10.2105/AJPH.2016.303366.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Kangovi S, Mitra N, Grande D, Huo H, Smith RA, Long JA. Community health worker support for disadvantaged patients with multiple chronic diseases: a randomized clinical trial. Am J Public Health. October 1, 2017;107(10):1660–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Kong W, Saunders E. Community programs to increase hypertension control. J Natl Med Assoc. 1989;81(suppl):13–6.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Ferdinand KC. Lessons learned from the healthy heart community prevention project in reaching the African American population. J Health Care Poor Underserved. 1997;8:366–71.CrossRefPubMedGoogle Scholar
  16. 16.
    Hess PL, Reingold JS, Jones J, Fellman MA, Knowles P, Ravenell JE, et al. Barbershops as hypertension detection, referral, and follow-up centers for black men. Hypertension. 2007 May 1;49(5):1040–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Victor RG, Ravenell JE, Freeman A, Leonard D, Bhat DG, Shafiq M, et al. Effectiveness of a barber-based intervention for improving hypertension control in black men: the BARBER-1 study: a cluster randomized trial. Arch Intern Med. 2011;171:342–50.CrossRefPubMedGoogle Scholar
  18. 18.
    Rader F, Elashoff RM, Niknezhad S, Victor RG. Differential treatment of hypertension by primary care providers and hypertension specialists in a barber-based intervention trial to control hypertension in black men. Am J Cardiol. 2013;112(9):1421–6.  https://doi.org/10.1016/j.amjcard.2013.07.004.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Victor RG, Lynch K, Li N, Blyler C, Muhammad E, Handler J, et al. A cluster-randomized trial of blood-pressure reduction in black barbershops. N Engl J Med. 2018 Mar 12;  https://doi.org/10.1056/NEJMoa1717250.
  20. 20.
    Community Preventive Services Task Force. Team-based care to improve blood pressure control. Recommendation of the Community Preventive Services Task Force. Am J Prev Med. 2014;47(1):100–2.CrossRefPubMedGoogle Scholar
  21. 21.
    Proia KK, Thota AB, Njie GJ, et al. Team-based care and improved blood pressure control: a community guide systematic review. Am J Prev Med. 2014;47(1):86–99.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Dehmer SP, Baker-Goering MM, Maciosek MV, Hong Y, Kottke TE, Margolis KL, et al. Modeled health and economic impact of team-based care for hypertension. Am J Prev Med. 2016;50(5 suppl 1):S34–44.  https://doi.org/10.1016/j.amepre.2016.01.027.CrossRefPubMedGoogle Scholar
  23. 23.
    •• Whelton PK, Einhorn PT, Muntner P, Appel LJ, Cushman WC, Roux AV, et al. Research needs to improve hypertension treatment and control in African Americans. Hypertension. 2016;68(5):1066–72. Report presents findings of an ad hoc working group assembled by the National Heart, Lung, and Blood Institute (NHLBI) to assess research needs to improve prevention, treatment, and control of hypertension among African-Americans.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Jacob V, Chattopadhyay SK, Thota AB, Proia KK, Njie G, Hopkins DP, et al. Community Preventive Services Task Force. Economics of team-based care in controlling blood pressure: a community guide systematic review. Am J Prev Med. 2015 Nov 30;49(5):772–83.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Mills KT, Obst KM, Shen W, Molina S, Zhang H-J, He H, et al. Comparative effectiveness of implementation strategies for blood pressure control in hypertensive patients: a systematic review and meta-analysis. Ann Intern Med.  https://doi.org/10.7326/M17-1805.
  26. 26.
    Brownstein JN, Chowdhury FM, Norris SL, Horsley T, Jack L, Zhang X, et al. Effectiveness of community health workers in the care of people with hypertension. Am J Prev Med. 2007 May 31;32(5):435–47.CrossRefPubMedGoogle Scholar
  27. 27.
    Lopez PM, Islam N, Feinberg A, Myers C, Seidl L, Drackett E, et al. A place-based community health worker program: feasibility and early outcomes, New York City, 2015. Am J Prev Med. 2017 Mar 31;52(3):S284–9.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Community Preventive Services Task Force. Self-measured blood pressure monitoring improves outcomes: recommendation of the Community Preventive Services Task Force. Am J Prev Med. 2017 Sep 1;53(3):e115–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Schoenthaler A, Knafl GJ, Fiscella K, Ogedegbe G. Addressing the social needs of hypertensive patients: the role of patient–provider communication as a predictor of medication adherence. Cir Cardiovasc Qual Outcomes. 2017 Sep 1;10(9):e003659.CrossRefGoogle Scholar
  30. 30.
    Tulane Website: https://news.tulane.edu/pr/tulane-university-awarded-628-million-study-blood-pressure-control-low-income-patients. Accessed: December 29, 2017.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical Research & Leadership, School of Medicine and Health SciencesThe George Washington UniversityWashingtonUSA
  2. 2.Tulane Heart and Vascular InstituteTulane University School of MedicineNew OrleansUSA

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