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

Related Experiment Video

Updated: Oct 17, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
14:43

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

H J Ward1, D E Morisky, N B Lees

  • 1Department of Medicine, King/Drew Medical Center, Los Angeles, California 90059, USA. haward@cdrew.edu

American Journal of Hypertension
|March 4, 2000
PubMed

Insights

The Community Hypertension Intervention Project (CHIP) studied interventions to improve high blood pressure treatment adherence in minority populations. Targeted strategies, alongside clinic changes, can enhance patient satisfaction and blood pressure control.

Area of Science:

  • Public Health
  • Cardiovascular Disease Research
  • Health Disparities

Background:

  • Hypertension management is challenging in underserved minority populations.
  • Environmental and psychosocial factors significantly impact treatment adherence.
  • High blood pressure control remains suboptimal in many inner-city communities.

Purpose of the Study:

  • To investigate environmental and psychosocial factors influencing hypertension treatment adherence.
  • To evaluate the effectiveness of interventions combined with usual care for high blood pressure management.
  • To improve patient compliance and blood pressure control in a high-risk, underserved minority population.

Main Methods:

  • A 4-year longitudinal study involving 1367 inner-city patients (75% Black, 25% Hispanic).
  • Randomization to usual care or one of three interventions: counseling, home visits/discussion groups, or computerized tracking.
  • Assessment of patient satisfaction, treatment adherence, and blood pressure control.

Main Results:

  • Approximately 65% of participants presented with uncontrolled blood pressure levels.
  • Interventions were designed to address barriers in a predominantly low-income minority community.
  • The study included participants from both hospital-based and private community clinics.

Conclusions:

  • Structural clinic changes and targeted interventions can improve patient satisfaction.
  • Interventions are effective in increasing treatment adherence for hypertension.
  • Combined strategies lead to improved blood pressure control in vulnerable populations.

Related Concept Videos

Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Community Based Intervention01:30

Community Based Intervention

Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...