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Community intervention to reduce cardiovascular disease in Chicago (CIRCL-Chicago): protocol for a type 3 hybrid
Justin D Smith1, Allison J Carroll2, Yacob G Tedla3
1Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA. jd.smith@hsc.utah.edu.
Implementation Science : IS
|May 5, 2025
Summary
Community health programs show promise for improving hypertension control in African American and Black adults. This study tests a community-adapted intervention in Chicago to reduce cardiovascular disparities.
Area of Science:
- Public Health
- Implementation Science
- Cardiovascular Disease Research
Background:
- Hypertension disproportionately affects African American and Black (AA/B) adults in the U.S., with stagnant control rates contributing to health disparities.
- Systemic barriers like poverty and healthcare distrust impede effective hypertension management in AA/B communities.
- Community-based interventions, especially those involving faith-based organizations, offer a promising strategy to improve blood pressure control.
Purpose of the Study:
- To test the effectiveness of a community-adapted hypertension control program in South Side Chicago health centers.
- To address cardiovascular health disparities by integrating clinical and community-based approaches.
- To enhance the reach and effectiveness of evidence-based hypertension interventions in diverse urban settings.
Main Methods:
- A type 3 hybrid effectiveness-implementation study using a cluster-randomized trial with 16 clinics.
- Implementation of a community-adapted hypertension control bundle, with or without practice facilitation.
- Recruitment of 5,760 participants for a community-based hypertension registry, with primary outcome of intervention reach and secondary outcome of blood pressure control at 12 months.
Main Results:
- The study is designed to measure the reach of the adapted Kaiser bundle intervention among eligible patients.
- Blood pressure control rates will be assessed as a secondary outcome at 12 months post-enrollment.
- The study will evaluate the effectiveness of practice facilitation as a strategy to support implementation.
Conclusions:
- The CIRCL-Chicago study aims to reduce cardiovascular health disparities among AA/B adults.
- Findings may inform scalable models for hypertension control in diverse urban communities.
- Integrating community engagement and clinical strategies can improve hypertension management.
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