Overview
This study seeks to evaluate whether a community-partnered, multi-level health system strategy to manage elevated blood pressure (BP) in the community, either with a medical model of remote BP management (RBPM) alone or RBPM plus a social model with a community health worker (CHW), is more effective in controlling hypertension than standard community screening and referral to primary care.
Description
In this comparative effectiveness trial, the aim of this study is to answer the research question of whether a remote blood pressure (BP) management program (RBPM, inclusive of home BP monitoring and telehealth visits with a nurse or pharmacist) alone or an RBPM program with community health worker (CHW) support is more effective than standard screening with education and referral to primary care in controlling BP and addressing social determinants that lead to poor health outcomes, and whether either program is more effective than the other.
The two models, RBPM alone and RBPM+CHW, are based on the concept that disparities in hypertension control among Black, Latinx, and low-income populations exist because of inequities related to health system factors, as well as socioeconomic and lifestyle factors, the physical/built environment, sociocultural factors, and discriminatory policies. This study will test the hypothesis if a medical model deployed in the community in conjunction with a CHW-driven social model that offers the full continuum of care with attendance to the social determinants of health (SDoH) will be most effective in controlling and sustaining BP control.
Eligibility
Inclusion Criteria:
- Elevated BP, defined as an average resting BP of >=135/85 mmHg based on 3 consecutive blood pressure readings
Exclusion Criteria:
- People who are pregnant
- Those that have end stage renal disease on dialysis
- People receiving active chemotherapy