A clinic and community-based approach to hypertension control for an underserved minority population: design and methods

• Published in: American journal of hypertension 2000-02, Vol.13 (2), p.177-183
• Main Authors: Ward, H.J, Morisky, D.E, Lees, N.B, Fong, R
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; community-based interventions; Female; Health Status; Humans; Hypertension - prevention & control; Longitudinal Studies; Male; Medical sciences; Medically Underserved Area; Middle Aged; Minority Groups; Patient Satisfaction; Preventive Health Services - methods; Preventive Health Services - standards; Randomized clinical trial; Research Design; Risk Factors; Social Class; Surveys and Questionnaires; underserved minorities
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(99)00149-1

This paper describes the design and methodology of the Community Hypertension Intervention Project (CHIP). CHIP is investigating the environmental and psychosocial factors related to treatment adherence and examining the effects of combining usual hypertension care with the effects of three interventions designed to improve patient compliance with treatment for high blood pressure in a high-risk, underserved minority population. Thirteen hundred and sixty-seven inner-city hypertension patients (75% black and 25% Hispanic) have agreed to participate in the 4-year longitudinal study. These participants were randomized to usual care or one of three intervention groups: individualized counseling sessions; home visits/discussion groups; or computerized appointment-tracking system. Participants are representative of the surrounding, predominantly low-income minority community and are treated in a hospital-based clinic and in a private clinic in the community. About 65% have blood pressure levels considered to be out of control. It was concluded that structural changes at the clinic site, along with the targeted interventions, would improve patient satisfaction, increase treatment adherence, and improve blood pressure control.