Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving Blood Pressure Control Together
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Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; 2Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; 3Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; 4Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 5Johns Hopkins Center for Health Equity, Johns Hopkins University, MD, USA; 6Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD, USA; 7Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; 8Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; 9Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 10Johns Hopkins Community Physicians, Johns Hopkins Medicine, Baltimore, MD, USA; 11Division of General Medicine, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA; 12Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; 13Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; 14Community Advisory Board, Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, Baltimore, MD, USA; 15Institute for Public Health Innovation, Washington, DC, USA; 16Sisters together and Reaching, Inc., Baltimore, MD, USA; 17Men and Families Center, Inc., Baltimore, MD, USA; 18American Heart Association, Baltimore, MD, USA; 19Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD, USA.
BACKGROUND: Effective hypertension self-management interventions are needed for socially disadvantaged African Americans, who have poorer blood pressure (BP) control compared to others. OBJECTIVE: We studied the incremental effectiveness of contextually adapted hypertension self-management interventions among socially disadvantaged African Americans. DESIGN: Randomized comparative effectiveness trial. PARTICIPANTS: One hundred fifty-nine African Americans at an urban primary care clinic. INTERVENTIONS: Participants were randomly assigned to receive (1) a community health worker (“CHW”) intervention, including the provision of a home BP monitor; (2) Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11606-019-05396-7) contains supplementary material, which is available to authorized users. Received October 23, 2018 Revised May 15, 2019 Accepted August 12, 2019
the CHW plus additional training in shared decisionmaking skills (“DoMyPART”); or (3) the CHW plus additional training in self-management problem-solving (“Problem Solving”). MAIN MEASURES: We assessed group differences in BP control (systolic BP (SBP) < 140 mm Hg and diastolic
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