The 130th Annual Meeting of APHA

Abstract #47383

Martha Hill, PhD, RN¹, Mary Roary, MHS¹, Dwyan Y. Monroe, BA², Lee Bone, MPH, RN¹, Miyong Kim, RN, PhD³, and Hae-Ra Han, RN, PhD³. (1) Johns Hopkins Medical Institutions, 525 N. Wolfe St., Baltimore, MD 21205, (2) School of Nursing, Center for Nursing Research, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD 21205, (3) The Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, 410-614-1443, mnhill@son.jhmi.edu

Using an innovative model to deliver health care, a nurse practitioner-community health worker-physician (NP/CHW/MD) team, working closely with indigent urban black men with hypertension (HBP) and a key supporter (family or friend), reached out to this underserved population to lower their blood pressure (BP). A sample of 309 hypertensive black men in Baltimore were randomized into either the more intensive (MI) or less intensive (LI) group, received a telephone call every 6 months, and were evaluated annually over 36 months. The MI group visited the NP every 1-3 months receiving free hypertensive medication; social services referrals and an annual home visit by the CHW; and MD consultation as needed. The LI group received HBP education and referral to sources of usual care available in the community. Follow-up rates were at or exceeding 70%, or 90% when adjusted for deceased, incarcerated, or moved out of state, at every follow-up for both groups. BP was significantly (p < 0.05) lower in the MI group at 36 months (138/88 mm Hg vs. 148/94 mm Hg). In addition, the proportion of men with controlled BP (< 140/90 mm Hg) was significantly higher in the MI group (44%) than the LI group (31%). While only limited systems are in place to support efforts to improve the care delivered to this high-risk vulnerable population, our clinic and community-based interdisciplinary approach, as an alternative to traditional medical care, is effectively addressing psychosocial and environmental barriers to care.

Learning Objectives: At the conclusion of the sessoin, the participant in this session will be able to

• Describe the effect of a comprehensive intervention by a nurse practitioner-community health worker-physician team on lowering blood pressure in urban black men with hypertension;
• Identify strategies to reduce barriers to care among indigent urban black men

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.