Controlling Hypertension in Native American and Other Populations
| Status: | Active, not recruiting |
|---|---|
| Conditions: | High Blood Pressure (Hypertension) |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 21 - 79 |
| Updated: | 8/12/2018 |
| Start Date: | April 11, 2017 |
| End Date: | January 31, 2019 |
The study evaluates the use of automated motivational messages, visit reminders, and
medication reminders (using interactive voice response technology or text messages) to
improve blood pressure control among adults with hypertension that receive their care at the
First Nations Community Healthsource clinic in Albuquerque, New Mexico. Half of the
participants will receive usual care, while the other half will receive the automated calls
or text messages and have the option to receive home blood pressure monitors and/or designate
a care partner who will also receive messages. Participants will be followed for 12 months.
medication reminders (using interactive voice response technology or text messages) to
improve blood pressure control among adults with hypertension that receive their care at the
First Nations Community Healthsource clinic in Albuquerque, New Mexico. Half of the
participants will receive usual care, while the other half will receive the automated calls
or text messages and have the option to receive home blood pressure monitors and/or designate
a care partner who will also receive messages. Participants will be followed for 12 months.
American Indians and Alaskan Natives (AI/ANs) face pervasive health disparities in comparison
to other racial and ethnic groups in the United States. Treatment of hypertension is a pillar
of cardiovascular disease prevention. Hypertension is the most common chronic health
condition in the U.S. Uncontrolled hypertension increases the risk of acute myocardial
infarction, stroke, kidney failure, and congestive heart failure. Hypertension rates are
high, levels of control are low, and disparities in care are evident in AI/AN populations.
This study will take place at First Nations Community Healthsource (FNCH) in Albuquerque, New
Mexico. FNCH provides primary medical care to urban AI/AN and other socially disadvantaged
residents of the Albuquerque, New Mexico area. Approximately 40% of FNCH clients are AI/AN;
Diné (Navajo) is the most common tribal affiliation. Many other clients served by FNCH are
undocumented immigrants. Housing insecurity and homelessness are common.
This study will use a FNCH hypertension registry to identify all clients with hypertension
(regardless of race or ethnicity). From this group, the study will recruit 512 clients, and
randomize the participants without stratification to receive automated messages using an
interactive voice recognition and text message intervention or to continue in usual care.
Consistent with the principles of pragmatic randomized clinical trials, the study has few
exclusion criteria in order to maximize inclusion of clients and generalizability of
findings. Potentially eligible clients will be contacted by letter and phone. Those who
express interest will complete a baseline visit where they provide informed consent, complete
a baseline survey, and have blood pressure measured. The participants will then be randomized
either to the intervention or usual care arms. Individuals randomized to the intervention arm
will receive: reminders of upcoming appointments at FNCH; requests to reschedule missed
appointments; reminders to refill medications; and weekly motivational messages to encourage
self-care, appointment keeping, and medication-taking for hypertension. These participants
will be offered a home blood pressure monitor and trained to use it if they accept, and will
be asked if they wish to nominate a care partner to also receive notices of upcoming and
missed appointments. In additional to their usual visits at FNCH, all participants will
complete research visits with our study coordinators at 6 and 12 months, where they will
again have BP measured and complete brief surveys.
to other racial and ethnic groups in the United States. Treatment of hypertension is a pillar
of cardiovascular disease prevention. Hypertension is the most common chronic health
condition in the U.S. Uncontrolled hypertension increases the risk of acute myocardial
infarction, stroke, kidney failure, and congestive heart failure. Hypertension rates are
high, levels of control are low, and disparities in care are evident in AI/AN populations.
This study will take place at First Nations Community Healthsource (FNCH) in Albuquerque, New
Mexico. FNCH provides primary medical care to urban AI/AN and other socially disadvantaged
residents of the Albuquerque, New Mexico area. Approximately 40% of FNCH clients are AI/AN;
Diné (Navajo) is the most common tribal affiliation. Many other clients served by FNCH are
undocumented immigrants. Housing insecurity and homelessness are common.
This study will use a FNCH hypertension registry to identify all clients with hypertension
(regardless of race or ethnicity). From this group, the study will recruit 512 clients, and
randomize the participants without stratification to receive automated messages using an
interactive voice recognition and text message intervention or to continue in usual care.
Consistent with the principles of pragmatic randomized clinical trials, the study has few
exclusion criteria in order to maximize inclusion of clients and generalizability of
findings. Potentially eligible clients will be contacted by letter and phone. Those who
express interest will complete a baseline visit where they provide informed consent, complete
a baseline survey, and have blood pressure measured. The participants will then be randomized
either to the intervention or usual care arms. Individuals randomized to the intervention arm
will receive: reminders of upcoming appointments at FNCH; requests to reschedule missed
appointments; reminders to refill medications; and weekly motivational messages to encourage
self-care, appointment keeping, and medication-taking for hypertension. These participants
will be offered a home blood pressure monitor and trained to use it if they accept, and will
be asked if they wish to nominate a care partner to also receive notices of upcoming and
missed appointments. In additional to their usual visits at FNCH, all participants will
complete research visits with our study coordinators at 6 and 12 months, where they will
again have BP measured and complete brief surveys.
Inclusion Criteria:
- At least two prior visits to First Nations Community Healthsource with blood pressure
measurements, with at least one visit in the 24 months prior
- Hypertension
- Between ages 21-79
Exclusion Criteria:
- Another preferred site of primary care
- Significant impairment of vision and hearing
- Life-limiting illness
- Renal dialysis
- Receipt of home health care, hospice services or residence in a nursing home
- Dementia
- Pregnancy
- Current incarceration
- Homeless
- No land line or cellular phone access
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