Evaluating the Impact of a Hypertension Program for African Americans

Overview

Journal J Natl Med Assoc

Publisher Elsevier

Specialty General Medicine

Date 2006 Apr 21

PMID 16623074

Citations 6

Authors

Angelia M Paschal

Rhonda K Lewis

Arneatha Martin

Donna Dennis Shipp

Donna Sanders Simpson

Affiliations

Soon will be listed here.

Abstract

Although hypertension affects all racial and ethnic groups, its prevalence is highest in the African-American community. The goal of Healthy People 2010 is to reduce hypertension among African Americans from 40% to 16%. Although current levels remain high, culturally sensitive, community-based clinical projects might be helpful in addressing this problem. The goal of this study was to assess whether a community-based clinic's program was effective in improving blood pressure control among a sample of 134 African-American adults. The program design involved health education and physical fitness classes offered over a nine-month period, with blood pressure checks being conducted pre- and postphases to determine whether the program was effective in controlling high blood pressure. Health questionnaires were also administered pre- and posttest to assess whether health behaviors and perceived health status were influenced by the project. Two-thirds (70%) of the sample had high blood pressure at baseline and 43% at program conclusion. This was a statistically significant difference (p=0.003). Overall self-reported health survey results indicated improved health behaviors and health status changes. Findings suggest that culturally sensitive, community-based clinic programs that incorporate both health education and physical fitness might be effective in reducing hypertension among African Americans.

Citing Articles

The effect of education plus access on perceived fruit and vegetable consumption in a rural African American community intervention.

Barnidge E, Baker E, Schootman M, Motton F, Sawicki M, Rose F Health Educ Res. 2015; 30(5):773-85.

PMID: 26338985 PMC: 4668755. DOI: 10.1093/her/cyv041.

What are successful recruitment and retention strategies for underserved populations? Examining physical activity interventions in primary care and community settings.

Carroll J, Yancey A, Spring B, Figueroa-Moseley C, Mohr D, Mustian K Transl Behav Med. 2013; 1(2):234-51.

PMID: 24073048 PMC: 3717650. DOI: 10.1007/s13142-011-0034-2.

Community-based cardiovascular health interventions in vulnerable populations: a systematic review.

Walton-Moss B, Samuel L, Nguyen T, Commodore-Mensah Y, Hayat M, Szanton S J Cardiovasc Nurs. 2013; 29(4):293-307.

PMID: 23612036 PMC: 3859833. DOI: 10.1097/JCN.0b013e31828e2995.

The search for strategies to control hypertension.

Kotchen T Circulation. 2010; 122(12):1141-3.

PMID: 20823382 PMC: 2957809. DOI: 10.1161/CIRCULATIONAHA.110.978759.

Cost effectiveness analysis of a hypertension management program in patients with type 2 diabetes.

Ly D, Fu A, Alex F, Hebert C, Christopher H J Clin Hypertens (Greenwich). 2009; 11(3):116-24.

PMID: 19302422 PMC: 8673129. DOI: 10.1111/j.1751-7176.2009.00082.x.

References

Gerber J, Stewart D . Prevention and control of hypertension and diabetes in an underserved population through community outreach and disease management: a plan of action. J Assoc Acad Minor Phys. 1998; 9(3):48-52. View

Greiner B, Krause N, Ragland D, Fisher J . Occupational stressors and hypertension: a multi-method study using observer-based job analysis and self-reports in urban transit operators. Soc Sci Med. 2004; 59(5):1081-94. DOI: 10.1016/j.socscimed.2003.12.006. View

Levine D, Bone L, Hill M, Stallings R, Gelber A, Barker A . The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African-American population. Ethn Dis. 2003; 13(3):354-61. View

Esch T, Stefano G, Fricchione G, Benson H . Stress in cardiovascular diseases. Med Sci Monit. 2002; 8(5):RA93-RA101. View

Rich S, McLaughlin V . Detection of subclinical cardiovascular disease: the emerging role of electron beam computed tomography. Prev Med. 2001; 34(1):1-10. DOI: 10.1006/pmed.2000.0813. View

Baranowski T, Simons-Morton B, Hooks P, Henske J, Tiernan K, Dunn J . A center-based program for exercise change among black-American families. Health Educ Q. 1990; 17(2):179-96. DOI: 10.1177/109019819001700205. View

Wang Y, Wang Q . The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004; 164(19):2126-34. DOI: 10.1001/archinte.164.19.2126. View

Rehman S, Hutchison F, Hendrix K, Okonofua E, Egan B . Ethnic differences in blood pressure control among men at Veterans Affairs clinics and other health care sites. Arch Intern Med. 2005; 165(9):1041-7. DOI: 10.1001/archinte.165.9.1041. View

WARD H, Morisky D, Lees N, Fong R . A clinic and community-based approach to hypertension control for an underserved minority population: design and methods. Am J Hypertens. 2000; 13(2):177-83. DOI: 10.1016/s0895-7061(99)00149-1. View

10.

Hill M, Han H, Dennison C, Kim M, Roary M, Blumenthal R . Hypertension care and control in underserved urban African American men: behavioral and physiologic outcomes at 36 months. Am J Hypertens. 2003; 16(11 Pt 1):906-13. DOI: 10.1016/s0895-7061(03)01034-3. View

11.

Karanja N, Stevens V, Hollis J, Kumanyika S . Steps to soulful living (steps): a weight loss program for African-American women. Ethn Dis. 2002; 12(3):363-71. View

12.

Cooper L, Hill M, Powe N . Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. J Gen Intern Med. 2002; 17(6):477-86. PMC: 1495065. DOI: 10.1046/j.1525-1497.2002.10633.x. View

13.

Hargreaves M, Schlundt D, Buchowski M . Contextual factors influencing the eating behaviours of African American women: a focus group investigation. Ethn Health. 2003; 7(3):133-47. DOI: 10.1080/1355785022000041980. View

14.

Nine S, Lakies C, Jarrett H, Davis B . Community-based chronic disease management program for African Americans. Outcomes Manag. 2003; 7(3):106-12. View

15.

Douglas J . Clinical guidelines for the treatment of hypertension in African Americans. Am J Cardiovasc Drugs. 2005; 5(1):1-6. DOI: 10.2165/00129784-200505010-00001. View

16.

Paschal A, Lewis R, Martin A, Dennis-Shipp D, Simpson D . Baseline assessment of the health status and health behaviors of African Americans participating in the activities-for-life program: a community-based health intervention program. J Community Health. 2004; 29(4):305-18. DOI: 10.1023/b:johe.0000025328.35205.cd. View

17.

Young D, Aickin M, Brantley P, Elmer P, Harsha D, King A . Physical activity, cardiorespiratory fitness, and their relationship to cardiovascular risk factors in African Americans and non-African Americans with above-optimal blood pressure. J Community Health. 2005; 30(2):107-24. DOI: 10.1007/s10900-004-1095-7. View

18.

Brach C, Fraser I . Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev. 2000; 57 Suppl 1():181-217. PMC: 5091811. DOI: 10.1177/1077558700057001S09. View

19.

James D . Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model. Ethn Health. 2004; 9(4):349-67. DOI: 10.1080/1355785042000285375. View

20.

Cooper L, Roter D, Johnson R, Ford D, Steinwachs D, Powe N . Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003; 139(11):907-15. DOI: 10.7326/0003-4819-139-11-200312020-00009. View