Ursua Rhodora A, Aguilar David E, Wyatt Laura C, Trinh-Shevrin Chau, Gamboa Leonida, Valdellon Pacita, Perrella Esperanza G, Dimaporo Mohammad Z, Nur Potrirankamanis Q, Tandon S Darius, Islam Nadia S
Alameda Health Consortium, San Leandro, CA, United States.
Community Collaborative Solutions, LLC, New Providence, NJ, United States.
Prev Med Rep. 2018 May 9;11:42-48. doi: 10.1016/j.pmedr.2018.05.002. eCollection 2018 Sep.
Behavioral interventions utilizing community health workers (CHWs) have demonstrated effectiveness in improving hypertension disparities in ethnic minority populations in the United States, but few have focused on Asian Americans. We assessed the efficacy of a CHW intervention to improve hypertension management among Filipino Americans with uncontrolled blood pressure (BP) in New York City (NYC) from 2011 to 2013. A total of 240 Filipino American individuals (112 in the treatment group and 128 in the control group) with uncontrolled hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg) were recruited from community-based settings in NYC. Using a community-based participatory research approach, treatment participants received 4 educational workshops and 4 one-on-one visits with CHWs over a 4-month period, while control group participants received 1 educational workshop. Main outcome measures included BP control, changes in SBP and DBP, and changes in appointment keeping at 8-months. At 8-months, BP was controlled among a significantly greater percentage of treatment group participants (83.3%) compared to the control group (42.7%). The adjusted odds of controlled BP for the treatment group was 3.2 times the odds of the control group ( < 0.001). Both groups showed decreases in SBP and DBP, with greater decreases among treatment participants. Significant between-group differences were also demonstrated in adjusted analyses ( < 0.001). Individuals in the treatment group showed significant changes in appointment keeping. In conclusion, a community-based intervention delivered by CHWs can help improve BP and related factors among Filipino Americans with hypertension in NYC.
利用社区卫生工作者（CHW）开展的行为干预已证明在改善美国少数族裔人群的高血压差异方面有效，但很少有干预措施关注亚裔美国人。我们评估了2011年至2013年期间在纽约市（NYC）开展的一项由社区卫生工作者实施的干预措施对改善血压控制不佳的菲律宾裔美国人高血压管理的效果。从NYC的社区环境中招募了总共240名血压控制不佳（收缩压≥140 mmHg和/或舒张压≥90 mmHg）的菲律宾裔美国人（治疗组112人，对照组128人）。采用基于社区的参与性研究方法，治疗组参与者在4个月内接受了4次教育工作坊和4次与社区卫生工作者的一对一探访，而对照组参与者仅接受了1次教育工作坊。主要结局指标包括血压控制情况、收缩压和舒张压的变化以及8个月时就诊依从性的变化。在8个月时，与对照组（42.7%）相比，治疗组参与者中血压得到控制的比例显著更高（83.3%）。治疗组血压得到控制的调整后比值是对照组的3.2倍（P<0.001）。两组的收缩压和舒张压均有所下降，治疗组参与者的下降幅度更大。在调整分析中也显示出显著的组间差异（P<0.001）。治疗组个体的就诊依从性有显著变化。总之，由社区卫生工作者实施的基于社区的干预措施有助于改善NYC高血压菲律宾裔美国人的血压及相关因素。
