A Faith-Based Intervention to Reduce Blood Pressure in Underserved Metropolitan New York Immigrant Communities

Abstract

Minority populations, including Asian Americans, face disparities in hypertension compared with non-Hispanic whites. This underscores the need for culturally adapted programs in settings that reach Asian American communities, such as faith-based organizations. We worked collaboratively with community partners to culturally adapt and implement an evidence-based community blood pressure monitoring program for Asian Americans (Asian Indians, Koreans, Filipinos, and Bangladeshis) in metropolitan New York during 2015 and 2016. The program included regularly scheduled volunteer-led screening and counseling events with congregants at faith-based organizations. Among participants with complete 6-month data (n = 348), health-related self-efficacy significantly improved after 6 months, and systolic and diastolic blood pressure was significantly reduced in some subgroups; reductions were highest in participants who self-reported a previous diagnosis of hypertension. Among Asian Americans, faith-based programs may be a replicable, low-cost, sustainable way to increase health-related self-efficacy and decrease blood pressure, specifically among individuals with self-reported hypertension.

Implementing Hypertension Management Interventions in Immigrant Communities in the U.S.: a Narrative Review of Recent Developments and Suggestions for Programmatic Efforts

“…Overall, 11 studies representing 10 distinct hypertension interventions were identified (Table 1 ). Populations of focus included immigrants of African [ 37 ••, 38 ], Filipino [ 39 ••, 40 ], Hispanic or Latino (unspecified nationalities) [ 41 , 42 ••, 43 ], Chinese [ 44 ], South Asian [ 45 ••, 46 ], and multiple Asian [ 47 ••] descents. Most studies ( n = 6) did not involve a control group and employed a pre-post-quasi experimental study design [ 37 , 38 , 42 ••, 43 , 44 , 47 ], including one stepped-wedge quasi-experimental intervention [ 45 ••, 46 ] and two randomized controlled trials [ 39 ••, 41 ].…”

“…Populations of focus included immigrants of African [ 37 ••, 38 ], Filipino [ 39 ••, 40 ], Hispanic or Latino (unspecified nationalities) [ 41 , 42 ••, 43 ], Chinese [ 44 ], South Asian [ 45 ••, 46 ], and multiple Asian [ 47 ••] descents. Most studies ( n = 6) did not involve a control group and employed a pre-post-quasi experimental study design [ 37 , 38 , 42 ••, 43 , 44 , 47 ], including one stepped-wedge quasi-experimental intervention [ 45 ••, 46 ] and two randomized controlled trials [ 39 ••, 41 ]. Diverse regions of the U.S. with large populations of immigrants were represented, including California [ 37 ••, 44 ], Texas [ 38 , 42 ••], Pennsylvania [ 39 ••], South Carolina [ 41 ], Florida [ 43 ], and New York [ 40 , 45 ••, 46 , 47 ••].…”

“…Most studies ( n = 6) did not involve a control group and employed a pre-post-quasi experimental study design [ 37 , 38 , 42 ••, 43 , 44 , 47 ], including one stepped-wedge quasi-experimental intervention [ 45 ••, 46 ] and two randomized controlled trials [ 39 ••, 41 ]. Diverse regions of the U.S. with large populations of immigrants were represented, including California [ 37 ••, 44 ], Texas [ 38 , 42 ••], Pennsylvania [ 39 ••], South Carolina [ 41 ], Florida [ 43 ], and New York [ 40 , 45 ••, 46 , 47 ••]. One protocol for a hypertension intervention in immigrant adults during the COVID-19 pandemic was also identified [ 37 ••].…”

“…Importantly, efforts to both maintain these collaborations after the intervention period and foster long-term community collaborations are pivotal to not only sustaining blood pressure control, but also enhancing efficacy and reach of future intervention efforts. For example, pre-existing community-coalitions from past research intervention efforts were used by Yi et al in identifying study sites [ 47 ••], with the design of the intervention itself also tailored to align with the organizational structure and priorities of community partners. Indeed, the health needs of immigrants are diverse and interconnected [ 57 ], thus collaborating with community stakeholders across multiple integration efforts and designing hypertension interventions to both build upon past coalitions as well as set up the framework for future sustained partnerships can be instrumental in demonstrating that the broader wellbeing of immigrant communities is at the core of research.…”

Acceptability of capnography-assisted respiratory therapy: a new mind–body intervention for COPD

“…1). [30][31][32][33][34] The intervention evaluation questions were developed based on the Social Cognitive Theory with a focus on questions related to how the intervention addressed self-management strategies, including self-efficacy and behavior change. 35,36 The interview guide was amended as new concepts were identified in order to further explore and understand emerging theoretical constructs.…”