Reducing hypertension among Filipino Americans through Project Aspire community health worker intervention

Background/Significance: Filipino Americans (FAs) have one of the highest rates of hypertension in the United States, yet few interventions address this population. Objective/Purpose: To highlight findings from a community-based 8-month randomized controlled community health worker (CHW) intervention (Project AsPIRE - Asian American Partnerships in Research and Empowerment) aimed at improving hypertension control among FAs in New York City. Methods: Measures, including clinical outcomes and behaviors related to hypertension management, were collected at baseline, 4-months, and 8-months. Preliminary analyses were performed on 62 treatment participants and 78 control participants who had completed 8-month surveys. The intervention is currently ongoing and will be complete in March of 2013. A total of 237 individuals have been randomized into the study. Results: Compared to baseline, at 8-months the treatment group had a mean change in systolic blood pressure of -27.0mmHg and diastolic blood pressure of -10.9mmHg (p<0.001) while the control group had a mean change in systolic blood pressure of -9.2mmHg (p<0.001) and diastolic blood pressure of -3.5mmHg (p<0.01); blood pressure reduction was significantly greater for the treatment group (p<0.001). The treatment group was also more likely to exhibit controlled blood pressure at 8 months (90.5% vs. 56.4%, p<0.001). Adapted Hill-bone compliance scales for appointment keeping and medication adherence were assessed. The treatment group displayed greater medication adherence at 8-months (p<0.01), while the control group did not display a significant change. Both groups demonstrated improved appointment keeping at 8-months; change was more significant in the treatment group (p<0.01 vs. p<0.05). Further findings to be presented include analyses adjusting for repeated measures using linear mixed models. Discussion/Conclusions: Positive changes in hypertension management and associated behaviors were seen in this preliminary analysis of Project AsPIRE. CHWs are an integral part of the health care team, and this model can be sustained within a community-based setting.