IMPROVING ADHERENCE TO INTERVENTIONS FOR HYPERTENSION

提高高血压干预措施的依从性

• 批准号: 2028997
• 负责人: Harry J Ward
• 金额: $ 75.93万
• 依托单位: CHARLES R. DREW UNIVERSITY OF MED & SCI
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 1998-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2028997
• 关键词: African American; antihypertensive agents; cardiovascular disorder chemotherapy; community health services; essential hypertension; health education; human subject; human therapy evaluation; kidney function; quality of life; questionnaires; therapy compliance; urban area

The primary objective of this four-year proposal is to develop effective strategies for enhancing adherence to therapeutic interventions designed to improve care for hypertensive minority populations. An aggressive Hypertension Intervention Project (HIP) will be developed in the Hypertension Research Section of King/Drew Medical Center in South- Central Los Angeles. The private CHUER clinic (located in the same cachement area) will subcontract with the Drew University Center in a community coalition consisting of several large health advocacy organizations. The applicant proposes to enroll over 1 ,800 new and existing hypertensive subjects. Over three-quarters of the patients will be African-Americans, with the remaining 25 percent Hispanic, reflecting the demographics of our cachement area. All 1800 subjects will be randomized into usual care (controls) or interventional care (experimental) at the initiation of the HIP. The cornerstone of our aggressive intervention will be the development of a computerized patient tracking system and the introduction into clinic of several educational activities including a) exit interviews; b) home visits; c) support group sessions, and d) community health seminars/fairs. Community Health Workers will perform the bulk of the patient tracking and educational intervention field work. Outcome measures of pre and post-study blood pressure, renal function, body weight change, and all-cause mortality will be compared between experimental and controls at two, three and four years into the study. Quality-of-life questionnaires will be obtained pre and post-study and analyzed for new insights into needs assessment, awareness of hypertension, attitudes towards treatment, compliance with drug therapy, and effectiveness of various educational interventions employed in the study. Concurrent efforts to reduce co-morbid risk factors such as obesity, cigarette smoking, excessive alcohol consumption and stress will be assessed as secondary outcomes. The HIP will hope to demonstrate cost-effective innovations for the adaptation of these Medical Center-targeted strategies to community physicians and health clinics of the inner city.

这四年提案的主要目的是发展有效 增强对治疗干预措施的依从性的策略 改善高血压少数族裔的护理。一个侵略性 高血压干预项目（HIP）将在 South-King/Drew医疗中心的高血压研究区 中央洛杉矶。私人Chuer诊所（位于同一诊所 缓存区）将与德鲁大学中心分包合同 社区联盟由几个大型健康倡导组成 组织。申请人建议注册超过1、800新的，并且 现有的高血压学科。超过四分之三的患者将 成为非裔美国人，剩余的25％的西班牙裔，反映 我们的缓存区域的人口统计。所有1800个受试者将是 随机分为通常的护理（控制）或介入护理 （实验）髋关节开始时。我们的基石 积极的干预将是计算机患者的发展 跟踪系统和一些教育的诊所的引入 包括a）退出访谈的活动； b）家庭访问； c）支持小组 会议和d）社区健康研讨会/博览会。社区健康 工人将进行大部分患者跟踪和教育 干预现场工作。研究前和研究后血液的结果度量 压力，肾功能，体重改变和全因死亡率 将在两个，三和四的实验和对照之间进行比较 研究几年。将获得终身质量问卷 和研究后，分析了对需求评估的新见解， 对高血压的认识，对治疗的态度，遵守 药物疗法和各种教育干预的有效性 在研究中使用。同时努力降低合并风险 肥胖，吸烟，饮酒过多等因素 压力将被评估为次要结果。臀部希望 展示了对这些改编的成本效益的创新 针对社区医生和健康的策略对医疗中心的策略 内城的诊所。