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Outcomes of a multi-community hypertension implementation study: the American Heart Association's Check. Change.
Monique L Anderson1,2, Rachel Peragallo Urrutia3, Emily C O'Brien1
1Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
Insights
Community-based blood pressure (BP) programs show potential for improving hypertension management. The American Heart Association
Area of Science:
- Public Health
- Cardiovascular Disease Prevention
- Community Interventions
Background:
- Community-based blood pressure (BP) interventions show promise for improving hypertension management.
- Scaling successful single-site programs to multiple communities presents unique challenges.
Purpose of the Study:
- To evaluate the scalability and effectiveness of the American Heart Association's Check. Change. Control. (CCC) program across multiple communities.
- To identify factors associated with successful BP intervention outcomes in a scaled community program.
Main Methods:
- A multi-site evaluation of the CCC program involving 4069 patients across 18 cities.
- Assessment of program effectiveness based on enrollment goals, participant engagement, and BP changes.
- Analysis of site-specific strategies, including recruitment methods, educational activities, and resource utilization.
Main Results:
- The CCC program demonstrated potential for BP improvements in community settings.
- Significant variability in outcomes was observed across different program sites.
- High-enrolling sites utilized senior residential institutions and service organizations; high-engagement sites focused on education and follow-up.
Conclusions:
- Simplified, community-based hypertension intervention programs can lead to BP improvements.
- Program success is influenced by factors such as recruitment strategies, participant engagement, and resource availability.
- Findings offer guidance for optimizing future community-based hypertension management programs.
Abstract:
Single-site, intensive, community-based blood pressure (BP) intervention programs have led to BP improvements. The authors examined the American Heart Association's Check. Change.
Control:
(CCC) program (4069 patients/18 cities) to determine whether BP interventions can effectively be scaled to multiple communities, using a simplified template and local customization. Effectiveness was evaluated at each site via site percent enrollment goals, participant engagement, and BP change from first to last measurement. High-enrolling sites frequently recruited at senior residential institutions and service organizations held hypertension management classes and utilized established and new community partners. High-engagement sites regularly held hypertension education classes and followed up with participants. Top-performing sites commonly distributed BP cuffs, checked BP at engagement activities, and trained volunteers. CCC demonstrated that simplified community-based hypertension intervention programs may lead to BP improvements, but there was high outcomes variability among programs. Several factors were associated with BP improvement that may guide future program development.
