Barber-Based Intervention for Hypertension in Black Men

基于理发师的黑人高血压干预措施

• 批准号: 7151340
• 负责人: Ronald G Victor
• 金额: $ 71.07万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-12 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7151340
• 关键词: African American; behavioral /social science research tag; behavioral medicine; blood pressure; cardiovascular disorder diagnosis; cardiovascular disorder risk; clinical research; community; education evaluation /planning; health behavior; health care referral /consultation; health care service utilization; health education; health surveys; human subject; human therapy evaluation; hypertension; interview; male; mathematical model; occupations; peer group; perception; social psychology; social support network

DESCRIPTION (provided by applicant): Non-Hispanic Black men suffer and die disproportionately from undetected, untreated, and uncontrolled hypertension: a chronic asymptomatic medical condition that requires frequent surveillance, prescription medication, and continuity of care by a regular medical provider. To improve hypertension detection, treatment, and control in Black men, we propose a randomized controlled trial to evaluate a well-informed and feasible behavior theory-based intervention conducted by barbers, influential peers who will continually monitor their customers' blood pressure (BP), deliver health messages designed to change risk perception and social norms about healthcare utilization, and provide social support for desired changes in healthcare- seeking behavior and BP. Our major hypothesis is that a continuous high BP detection and medical referral program conducted by influential peers in a receptive community setting (barbershops) will change social norms about healthcare utilization, promote treatment-seeking behavior, and thus lower BP among the regular customers with high BP. The specific behavioral objectives are to: 1) Increase the measurement of BP during haircuts and the recognition of elevated readings; 2) Increase new referrals to regular medical providers for untreated hypertension, and 3) Increase follow-up medical appointments for under-treated hypertension. To accomplish these objectives, Social Cognitive Theory/Community PROMISE (Peers Reaching Out and Modeling Intervention Strategies) will drive the intervention in which nurses will train and supervise barbers to measure BP and deliver health messages to barbershop customers at each haircut visit. To test our hypothesis, a cohort of 24 previously unstudied barbershops will go through a group- randomization protocol. Four new shops will be enrolled every two months. Serial cross-sectional BP surveys (each lasting 8 weeks) will be conducted by trained interviewers to obtain accurate snap-shots of hypertension control in each of the 24 barbershops before and after a 10-month intervention period consisting of either barber-based intervention or no active intervention. The multilevel analysis plan utilizes hierarchical modeling to address clustering of observations within barbershops and other important covariates. A detailed dissemination plan is proposed as the potential for dissemination is high; there are over 18,000 Black barbershops in major urban centers across the United States.

描述（由申请人提供）：非西班牙裔黑人因未发现，未经治疗和不受控制的高血压而遭受不成比例的痛苦：一种慢性无症状的医疗状况，需要经常进行监视，处方药和常规医疗服务提供者的护理连续性。为了改善黑人男性的高血压检测，治疗和控制，我们提出了一项随机对照试验，以评估由理发师进行的良好且可行的基于行为理论的基于行为理论的干预措施，有影响力的同龄人将不断监视客户的血压（BP），旨在提供旨在改变有关医疗保健利用率的风险和社会保健服务的健康和社交支持，并寻求社会支持的行为和不断发展的健康状况。我们的主要假设是，有影响力的同伴在接受社区环境（理发店）中进行的连续高BP检测和医疗转诊计划将改变有关医疗保健利用的社会规范，促进寻求治疗的寻求治疗行为，从而在较高BP的常规客户中降低BP。具体的行为目标是：1）增加发型期间BP的测量以及对读数升高的识别； 2）将新的推荐人推荐给常规医疗提供者，以提高未经治疗的高血压，3）增加治疗高压治疗的后续医疗预约。为了实现这些目标，社会认知理论/社区的承诺（同伴接触并建模干预策略）将推动护士将在每次理发访问时培训和监督理发师培训和监督理发师的干预措施，以衡量BP并向Barbershop客户传递健康信息。为了检验我们的假设，由24个先前未研究的理发店组成的队列将通过一个团体随机性方案。每两个月将每隔四家新的商店就读。训练有素的访调员将在10个月前和之后的24个理发店中的每一个中的每一个中，在24个理发店中的每一个中，都将进行序列横截面BP调查（每次持续8周），以获得准确的高血压控制射击，该次数包括理发措施或无主动干预。多层次分析计划利用层次建模来解决理发店和其他重要协变量内观测值的聚类。提出了详细的传播计划，因为传播的潜力很高。美国主要城市中心有18,000多个黑人理发店。