Community Targeting of Uncontrolled Hypertension: Results of a Hypertension Screening and Education Intervention in Community Churches Serving Predominantly Racial/Ethnic Minority Populations

Abstract

Background. Uncontrolled hypertension is the primary risk factor for the development of cardiovascular complications and particularly burdens racial/ethnic minority populations. Aim. To determine the effectiveness of a community hypertension screening, education, and empowerment intervention on blood pressure (BP) improvement. Method. We screened 152 participants across four churches in predominantly racial/ethnic minority neighborhoods for elevated BP. During this visit, those with BP ≥ 140/90 mmHg were enrolled in the study and completed interventions. Individuals with moderately elevated BP (≥140/90 and <160/100 mmHg; Group 1) viewed a 3-minute hypertension education video. Individuals with severely elevated BP (≥160/100 mmHg; Group 2) additionally viewed echocardiograms images with subclinical changes from uncontrolled hypertension and had a brief on-site medication review with a pharmacist. Both groups received automated BP monitors and information on neighborhood federally qualified health centers for primary care. Participants returned to each church for follow-up 3 months later. We analyzed BP difference at 3 months and percentage with controlled BP for each group. Results. For Group 1, mean baseline and follow-up BPs were 143.5/88.0 mmHg and 138.5/85.8 mmHg, respectively. For Group 2, BPs significantly decreased from 165.4/98.3 mmHg to 150.4/90.8 mmHg. After the intervention, participants with controlled BP for Groups 1 and 2 were 35.5% and 55.2%, respectively. Discussion. Participants in both groups had BP improvements. Greater improvements were in individuals at higher cardiovascular risk due to severely elevated BPs (≥160/100 mmHg). Conclusion. This pilot highlights the impact that streamlined empowerment interventions with dedicated health personnel can have in high-risk communities with elevated BPs.

Socioeconomic characteristics of African American women attending community blood pressure screenings

“…Additionally, they provide access to care for those who may not seek or have established medical care and offer an avenue for strategic partnerships with faith-based, civic, and community organizations fostering health promotion [ 18 – 20 ]. Although studies have documented the impact of various community health interventions targeting cardiovascular health among African American women [ 14 , 21 , 22 ], less is known regarding the relationship between SES and BP outcomes among its attendees.…”

Blood pressure reduction as a result of the Boxville Vitals partnership

“…In the CTOUCH study, 5 BP among two study groups was compared. In the Group 1 Stage 1 hypertension group, BP fell about 5 mm Hg for systolic BP and 3 mm Hg for diastolic BP.…”

“…The Boxville Vitals service met people at the exit of the train station and as they visited the marketplace. The location of the Boxville testing service was intentional to mirror the inclusive environment of the Black Barbershop and CTOUCH studies 4,5 …”

“…For example, Victor and colleagues illustrated in the Blood‐Pressure Reduction in Black Barbershops study the importance of meeting people, literally, where they are—for instance, in a barbershop 4 . In the Community Targeting of Uncontrolled Hypertension (CTOUCH) study conducted by Prendergast and colleagues, hypertension surveillance and counseling were provided in a church 5 . Both of these settings are significant for creating convenience for community members.…”

“…4 In the Community Targeting of Uncontrolled Hypertension (CTOUCH) study conducted by Prendergast and colleagues, hypertension surveillance and counseling were provided in a church. 5 Both of these settings are significant for creating convenience for community members. The interventions provided in those studies took place concurrently with other routine events, which minimizes structural barriers of access to care-transportation, appointment setting, and childcare, among others.…”