The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African-American population.

This study investigated the effectiveness of a community-academic health center partnership, utilizing nurse-supervised indigenous community health workers, in decreasing the blood pressure in an urban African-American population. A four-year randomized clinical trial was conducted in the Sandtown-Winchester community, which has an excess prevalence of high blood pressure, in order to test the effectiveness of 2 different levels of intervention intensity on increasing the control of high blood pressure. Community health workers were trained and certified in blood pressure management, monitoring, education and counseling, social support mobilization, and community outreach and follow up. The primary results were a significant decrease in mean systolic and diastolic pressures after both levels of intervention, and a significant increase in the percentage of individuals with controlled high blood pressure. Surprisingly, no differences in results were observed between the 2 levels of intervention intensity. This study supports the use of community-based partnership efforts, and the utilization of indigenous health workers, to enhance the control of high blood pressure in a high-risk, African-American urban population.

[1]  R. Gillum,et al.  Determinants of dropout rate among hypertensive patients in an urban clinic , 2005, Journal of community health.

[2]  Thomas P. Hettmansperger,et al.  Bowker's Test for Symmetry , 2004 .

[3]  Richard A. Johnson.  A clinic and community-based approach to hypertension control for underserved minority population: Design and methods , 2004 .

[4]  M. Hill,et al.  Barriers to hypertension care and control , 2000, Current hypertension reports.

[5]  S. Zeger,et al.  Community health survey in an urban African-American neighborhood: distribution and correlates of elevated blood pressure. , 2000, Ethnicity & disease.

[6]  C. Collier,et al.  Linking community-based blood pressure measurement to clinical care: a randomized controlled trial of outreach and tracking by community health workers. , 1999, American journal of public health.

[7]  R. Brownson,et al.  Demonstration projects in community-based prevention. , 1998, Journal of Public Health Management and Practice.

[8]  B. Israel,et al.  Review of community-based research: assessing partnership approaches to improve public health. , 1998, Annual review of public health.

[9]  M. Hill,et al.  Enhancing the role of community-health workers in research. , 1996, Image--the journal of nursing scholarship.

[10]  S. Zeger,et al.  Community-academic health center partnerships for underserved minority populations. One solution to a national crisis. , 1994, JAMA.

[11]  Scott L. Zeger,et al.  Generalized linear models with random e ects: a Gibbs sampling approach , 1991 .

[12]  M. Karim.  Generalized Linear Models With Random Effects , 1991 .

[13]  Keil Je,et al.  Urban and rural differences in cardiovascular disease in blacks. , 1991 .

[14]  J. Keil,et al.  Urban and rural differences in cardiovascular disease in blacks. , 1991, Cardiovascular clinics.

[15]  L. Bone,et al.  The impact of a planned health education approach on the control of hypertension in a high risk population. , 1990, Journal of human hypertension.

[16]  D. Strogatz,et al.  Social support and hypertension among blacks and whites in a rural, southern community. , 1986, American journal of epidemiology.

[17]  R P Russell,et al.  Five-year blood pressure control and mortality following health education for hypertensive patients. , 1983, American journal of public health.