Evaluation of a peer-led hypertension intervention for veterans: impact on peer leaders

Mosack, Katie E.; Patterson, Leslie; Brouwer, Amanda M.; Wendorf, Angela R.; Ertl, Kristyn; Eastwood, Dan; Morzinski, Jeffrey; Fletcher, Kathlyn E.; Whittle, Jeff

doi:10.1093/her/cyt004

Cited by 19 publications

(18 citation statements)

References 32 publications

(29 reference statements)

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“…Peer leaders underwent eight mini‐training sessions to equip them with a script to deliver the intervention. Hypertensive peer leaders lowered their systolic BP by 3.93 mm Hg ( P =.04) and engaged in healthier behaviors compared with leaders from other groups …”

Section: Resultsmentioning

confidence: 97%

“…We identified 27 articles representing 15 unique trials. Approximately 20% (n=3) of the interventions addressed patients and providers and 80% (n=12) focused on patients solely . All studies included patient‐directed education; 60% (n=9) of the studies also involved medication management.…”

Section: Resultsmentioning

confidence: 99%

“…Approximately 20% (n=3) of the interventions addressed patients and providers [2][3][4][5][6][7][8][9][10][11] and 80% (n=12) focused on patients solely. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] All studies included patient-directed education; 60% (n=9) of the studies 6,7,12,14,[18][19][20][23][24][25] also involved medication management.…”

Section: Resultsmentioning

confidence: 99%

“…Hypertensive peer leaders lowered their systolic BP by 3.93 mm Hg (P=.04) and engaged in healthier behaviors compared with leaders from other groups. 15…”

Section: Medication Management+behavioral Componentsmentioning

confidence: 99%

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Behavioral Interventions to Improve Hypertension Control in the Veterans Affairs Healthcare System

Zullig

Bosworth

2014

J of Clinical Hypertension

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Hypertension is a common and costly disease among US veterans. The Veterans Affairs (VA) healthcare system is the largest integrated healthcare provider in the United States and reviewing hypertension interventions developed in the VA may inform interventions delivered in other integrated healthcare systems. This review describes behavioral interventions to improve hypertension control that have been conducted in the VA since 1970. The authors identified 27 articles representing 15 behavioral interventional trials.Studies were heterogeneous across patients, providers, interventionist, and intervention components. The VA bridges services related to diagnosis, treatment, medication management, and behavioral counseling in a unified approach that supports collaboration and provides infrastructure for hypertension management. J Clin Hypertens (Greenwich). 2014;16:827-837. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.In recent decades there has been improvement in hypertension care provided in the Veterans Affairs (VA) healthcare system, the largest integrated healthcare provider in the United States. From 2000 to 2010, blood pressure (BP) control improved in the VA from 43.0% to 76.6%.1 There is a need for innovative behavioral approaches to continue and improve BP control. Reviewing hypertension interventions developed in the VA may inform interventions delivered in other systems. We performed a literature review describing behavioral hypertension interventions administered in the VA and distilled commonalities among successful programs. We emphasize behavioral management interventions because the success of BP control ultimately depends on a patient's willingness and ability to modify and maintain certain behaviors (eg, proper diet, exercise, and medication adherence). Therefore, our objective was not to report on VA hypertension care in general, but, rather, to focus on behavioral hypertension management interventions. METHODSA literature search using the PubMed database was conducted. We identified articles containing MeSH and key words addressing intervention studies or clinical trials, veterans, and hypertension. Articles were limited to those published in English in the past 44 years. Studies need not be solely conducted in the VA. This initial search yielded 171 articles. We screened full articles for eligibility. Exclusion criteria included: (1) commentary or editorial; (2) observational or retrospective analysis; (3) review article or solely described a conceptual mode; (4) not focused on hypertension; or (5) not a patient-focused behavioral hypertension intervention. The Figure outlines the article identification process. Interventions were divided into only behavioral or behavioral/medication management. We made this distinction because medication management interventions generally require complex design, necessitating the involvement and/or oversight of a clinician or pharmacist. RESULTSWe identified 27 articles representing 15 unique trials. Approximatel...

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Hypertensive peer leaders lowered their systolic BP by 3.93 mm Hg (P=.04) and engaged in healthier behaviors compared with leaders from other groups. 15…”

Section: Medication Management+behavioral Componentsmentioning

confidence: 99%

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Behavioral Interventions to Improve Hypertension Control in the Veterans Affairs Healthcare System

Zullig

Bosworth

2014

J of Clinical Hypertension

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“…[5][6][7] Peer support interventions addressing musculoskeletal pain and hypertension have also been implemented within VA health care settings resulting in improved health outcomes. 8,9 Within non-VA settings, buddy-to-buddy programs for service members have been developed to reduce stigma and cope with mental health symptoms. 10 Few have implemented peer support programs within community settings.…”

mentioning

confidence: 99%

Using Community Advisory Boards to Build Partnerships and Develop Peer-Led Services for Rural Student Veterans

Cheney¹,

Abraham²,

Sullivan³

et al. 2016

Progress in Community Health Partnerships

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What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map

Price

Bell

Shaw

et al. 2022

Campbell Systematic Reviews

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Background: Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions.Objectives: The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and costeffectiveness of the use of peer support in health and social care. Search Methods: We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies.Selection Criteria: Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role.

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Evaluation of a peer-led hypertension intervention for veterans: impact on peer leaders

Cited by 19 publications

References 32 publications

Behavioral Interventions to Improve Hypertension Control in the Veterans Affairs Healthcare System

Behavioral Interventions to Improve Hypertension Control in the Veterans Affairs Healthcare System

Using Community Advisory Boards to Build Partnerships and Develop Peer-Led Services for Rural Student Veterans

What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map

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