The proposed study "Project IMPACT: CHW Intervention" is part of a larger study examining the efficacy, adoption, and impact of integrated EHR-based decision-support and physician feedback interventions with community health worker (CHW)-led self-management and coaching support for South Asian patients with uncontrolled hypertension. This is a randomized control intervention utilizing community health worker (CHW)-led self-management and coaching support for South Asian patients with uncontrolled hypertension at PCP clinics in New York City.
The Goal of this study is that: 1. EHR-based decision support and performance feedback interventions will be more effective in improving hypertension control for South Asian patients than standard care; 2. A combined EHR-CHW intervention will be more effective in improving hypertension control for South Asian patients compared to standard care and the EHR-based intervention Investigators hope to implement and assess the efficacy of CHW-led coaching through promotion of team-based care and use of culturally tailored education to improve hypertension control and mitigate risk factors related to CVD among South Asian patients with uncontrolled hypertension. Study findings can provide translatable and scalable models for other limited English proficient communities.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
305
Patients randomized to Group A will be invited to attend 4 more group educational sessions on self-management immediately.CHWs will follow up with participants by phone or in person through a home or clinic visit. At these follow-up meetings, CHWs will engage in goal-setting activities regarding changes to health behaviors, medication adherence, or other issues related to hypertension control as identified jointly by the patient and CHW. CHWs will also collect height, weight, and blood pressure measurements at initial and in-person follow-up visits. The CHW will make necessary referrals to other services available in the community (i.e. exercise classes, social services, mental health, tobacco cessation, etc.).
4 education sessions beginning 6-12 months later.
New York University School of Medicine
New York, New York, United States
Percent of current diagnosed hypertensive patients with BP <140/90 (or BP<130/80 for patients with diabetes) at 6 Months
Time frame: 6 Months
Percent of current diagnosed hypertensive patients with BP <140/90 (or BP<130/80 for patients with diabetes) at 12 months
Time frame: 12 months
Percent of patients with HbA1c <7 (for patients with hypertension + diabetes) at 6 months
Time frame: 6 months
Percent of patients with diagnosis of hypertension with a BP measure taken in the past 6 months
Time frame: 6 months
Percent of patients without hypertension having valid BP measurement, last 12 months
Time frame: 12 months
Percent of current hypertensive patients screened for diabetes in last year
Time frame: 12 months
Percent of current hypertensive patients receiving counseling on BMI, diet and physical activity
Time frame: 12 months
Percent of current diagnosed hypertensive patients referred to a nutritionist in the past year
Time frame: 12 months
Percent of current diagnosed hypertensive patients who smoke who have been referred for smoking cessation
Time frame: 12 months
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