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The proposed study "Project IMPACT: CHW Intervention" is part of a larger study examining the efficacy, adoption, and impact of integrated EHR-based decision-support and physician feedback interventions with community health worker (CHW)-led self-management and coaching support for South Asian patients with uncontrolled hypertension. This is a randomized control intervention utilizing community health worker (CHW)-led self-management and coaching support for South Asian patients with uncontrolled hypertension at PCP clinics in New York City.
The Goal of this study is that:
Investigators hope to implement and assess the efficacy of CHW-led coaching through promotion of team-based care and use of culturally tailored education to improve hypertension control and mitigate risk factors related to CVD among South Asian patients with uncontrolled hypertension. Study findings can provide translatable and scalable models for other limited English proficient communities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CHW Intervention | Active Comparator | CHW lead Sessions Session1: BP and the Cardiovascular System Session 2: Nutrition and food labels Session 3: Physical Activity and Stress Management Session 4: CVD Risk factors: cholesterol, blood sugar, & Smoking Session 5: Health Communication, Healthcare access & Review |
|
| Control Group | Placebo Comparator | Wait-list |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CHW Intervention | Behavioral | Patients randomized to Group A will be invited to attend 4 more group educational sessions on self-management immediately.CHWs will follow up with participants by phone or in person through a home or clinic visit. At these follow-up meetings, CHWs will engage in goal-setting activities regarding changes to health behaviors, medication adherence, or other issues related to hypertension control as identified jointly by the patient and CHW. CHWs will also collect height, weight, and blood pressure measurements at initial and in-person follow-up visits. The CHW will make necessary referrals to other services available in the community (i.e. exercise classes, social services, mental health, tobacco cessation, etc.). |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of current diagnosed hypertensive patients with BP <140/90 (or BP<130/80 for patients with diabetes) at 6 Months | 6 Months | |
| Percent of current diagnosed hypertensive patients with BP <140/90 (or BP<130/80 for patients with diabetes) at 12 months | 12 months | |
| Percent of patients with HbA1c <7 (for patients with hypertension + diabetes) at 6 months | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of patients with diagnosis of hypertension with a BP measure taken in the past 6 months | 6 months | |
| Percent of patients without hypertension having valid BP measurement, last 12 months | 12 months |
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Inclusion Criteria:
CHW Intervention
Focus Group
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nadia Islam | NYU Langone Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New York University School of Medicine | New York | New York | 10016 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36815464 | Derived | Islam NS, Wyatt LC, Ali SH, Zanowiak JM, Mohaimin S, Goldfeld K, Lopez P, Kumar R, Beane S, Thorpe LE, Trinh-Shevrin C. Integrating Community Health Workers into Community-Based Primary Care Practice Settings to Improve Blood Pressure Control Among South Asian Immigrants in New York City: Results from a Randomized Control Trial. Circ Cardiovasc Qual Outcomes. 2023 Mar;16(3):e009321. doi: 10.1161/CIRCOUTCOMES.122.009321. Epub 2023 Feb 23. | |
| 29207983 |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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Step wedge design, whereby 5 groups of 3 practices will implement the intervention in phases.
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|
| Wait List Control Group | Behavioral | 4 education sessions beginning 6-12 months later. |
|
| Percent of current hypertensive patients screened for diabetes in last year | 12 months |
| Percent of current hypertensive patients receiving counseling on BMI, diet and physical activity | 12 months |
| Percent of current diagnosed hypertensive patients referred to a nutritionist in the past year | 12 months |
| Percent of current diagnosed hypertensive patients who smoke who have been referred for smoking cessation | 12 months |
| Derived |
| Lopez PM, Zanowiak J, Goldfeld K, Wyka K, Masoud A, Beane S, Kumar R, Laughlin P, Trinh-Shevrin C, Thorpe L, Islam N. Protocol for project IMPACT (improving millions hearts for provider and community transformation): a quasi-experimental evaluation of an integrated electronic health record and community health worker intervention study to improve hypertension management among South Asian patients. BMC Health Serv Res. 2017 Dec 6;17(1):810. doi: 10.1186/s12913-017-2767-1. |